Resonant Expertise and the COVID-19 Pandemic In

It’s (not) like the flu: Resonant Expertise and the COVID-19 Pandemic

in Mainland China, Hong Kong, and the United States

Larry Au1, Zheng Fu1, & Chuncheng Liu2

[email protected]; [email protected]; [email protected]

1. Department of Sociology, Columbia University

2. Department of Sociology, University of California San Diego

Authorship in alphabetical order, all authors contribute equally to this work

Abstract

Why did societies respond to COVID-19 differently? Unlike popular explanations relying on political or cultural differences, we examine the role that experts and expertise play in shaping the initial responses to COVID-19. We ask three specific questions: (1) Who were the COVID-

19 experts, (2) How was expertise mobilized to understand the emerging threat of COVID-19, and (3) How did these expert statements resonate with policymakers and publics in different political contexts? Through our three-case comparison of Mainland China, Hong Kong, and the United States, we show how past experiences with disease outbreaks shaped how experts deployed their expertise to make sense of the emerging crisis. Furthermore, past experiences with disease outbreaks also shape how these forms of expertise become resonant with policymakers and publics, as the past itself becomes a cultural object that is mobilized, contested, and seen as potentially useful to solve the problem of COVID-19. We argue that the process of resonant expertise played a key role in coming up with effective policies to tackle

COVID-19.

Keywords: Expertise, Global Health, COVID-19, China, United States, Hong Kong

1. Introduction

When the Coronavirus Disease 2019 (COVID-19) outbreak began, societies responded differently initially. Popular analyses attribute variations to factors such as political systems, regime type, and cultural norms (e.g., Jennings 2020; Martin and Walker 2020)—but these generalizations ignore the processes of mobilizing policymakers and publics in moments of crises. In comparing Mainland China (hereafter China), Hong Kong (hereafter H.K.), and the

United States (hereafter U.S.), we show the critical role of experts and expertise in initiating and shaping state and societal responses to COVID-19. We examine the resonance of different types of expertise as experts along with policymakers and the public try to come up with policies to contain and mitigate the outbreak.

We ask three specific questions: (1) Who were the COVID-19 experts, (2) How was expertise mobilized to understand the emerging threat of COVID-19, and (3) How did these expert statements resonate with policymakers and publics in different political contexts?

Through our three-case comparison, we show how the resonance of expertise as a process shaped the responses of societies to COVID-19, by enabling experts to see COVID-19 as a problem and by identifying the sets of policies that could help mitigate and contain COVID-

19 (McDonnell, Bail, and Tavory 2017). Our study details how the trauma of past epidemics, particularly, the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003 prompted societies like China and H.K., to act decisively on COVID-19. In our analysis, past experiences were evoked by experts and shaped the resonance of expertise, highlighting (1) how the past becomes a cultural object that is used by experts to mobilize stakeholders, and (2) how political contexts limit the scope of possible actions and determine the configuration of interests for stakeholders.

To distinguish between different types of expertise, we draw on Lakoff’s (2015b) distinction of sentinel devices or warnings of impending disaster because of unknowns, and

actuarial devices or calculations of risk based on prior events. While in China and H.K., the

SARS experience prompted “SARS experts” to mobilize sentinel devices to push for vigilance against COVID-19. But the SARS memory was both an effective warning and a challenge to the state. In China, resonant expertise needed to overcome the authoritarian impulses of local policymakers that sought to censor warnings from experts, and was achieved after top policymakers were convinced that COVID-19 was a SARS-like problem. In H.K., resonant expertise also had to overcome the reluctance of city policymakers to overreact and found an ally with the public, as civil society mobilized to pressure policymakers to adopt stricter anti- epidemic measures. The U.S. similarly had policymakers who were unwilling to recognize

COVID-19 as a growing problem. But with no immediate past experience of disease for experts to draw on, a wide range of experts mobilized both sentinel and actuarial devices. Amidst the backdrop of political polarization, different types of expertise resonated selectively with various audiences, but failed to achieved widespread resonance during the initial months of the pandemic.

2. Theoretical Framework

Our theoretical framework focuses on past experiences and the relationships between experts, policymakers, and the public, as well as how expertise becomes resonant with different stakeholders. We see expertise as central to the network that mobilizes timely and effective responses to COVID-19. Our starting point is Eyal’s (2013) distinction between experts and expertise: Experts are “the actors who make claims to jurisdiction over a task” (869); and expertise involves "networks that link together objects, actors, techniques, devices, and institutional and spatial arrangements" (864) that are mobilized to accomplish a task. In times of crisis, which type of expertise is seen as relevant becomes contested (Knowles 2012;

Whooley 2013). To differentiate abstractly between types of expert warnings, we build on

Lakoff's (2015b) distinction between sentinel devices and actuarial devices: Sentinel devices operate on the logic of vigilance, relying on systems of monitoring that flag potential catastrophic events; actuarial devices operate on the logic of risk management, using past data and future projections to model potential impact. These devices aid in future-coordination between stakeholders (Tavory and Eliasoph 2013), and are deployed by experts as interventions aimed at swaying policymakers and publics (Eyal and Buchholz 2010; Carduff

2015).

As we show, these types of expertise can be mobilized concurrently and past experience shapes different types of expertise mobilized. More critically, this expertise must become resonant become impactful. We draw on McDonnel, Bail, and Tavory’s (2017) pragmatic conceptualization of resonance as not simply congruence with past experience, but as a “the ability of cultural objects to help actors solve puzzles they face” (2). How the past matters differ from the path dependency theory where the future is “locked-in” (Pierson 2004); instead the past matters in an emergent process in which scientific, social, and political concerns are coproduced (Jasanoff 2004). In other words, expertise does not guarantee resonance: Work must be done to create resonance that speaks to the concerns of the stakeholders.

This is where past experience comes in. The past becomes a cultural object that is usable but also mutable and an object of struggle between experts, policymakers, and publics (Sewell

1990; Swidler 1986). Past experience can therefore help facilitate the resonance of expertise with different stakeholders. For instance, the resonance of a specific type of expertise can be facilitated by collective memories of past outbreaks, which intersects with individual cognition and a society’s stock of knowledge, shaping how individuals prioritize and think about infectious disease (Cerulo 2002; Olick and Robbins 1998; Zerubavel 1997). Similarly, the resonance of different forms of expertise can be shaped by the institutional repertoires of public health that were reconfigured by past outbreaks to focus on preparing for the next outbreak

(Heymann and Rodier 2004; Lakoff 2015a). In our case, we focused on examining the impacts of past experience with disease outbreaks on the COVID-19 responses.

Specifically, we highlight the legacy of the 2003 SARS epidemic, which accumulated 5327 cases in China and 1755 in H.K., with 348 and 298 death, respectively, in contrast to 75 cases and 0 deaths in the U.S. The memory of SARS was salient amongst people in China and H.K. associating with great social, economic, and political consequences: Both societies suffered greatly from economic lost, widespread social panic, and damaged international image (Huang

2004; J.-W. Lee and McKibbin 2004). China’s initial response to the SARS was delayed, lacked transparency, and ineffective, which intensified the epidemic (Huang 2004), but sparked a host of public health reforms that provided tools that policymakers could deploy in the event of another epidemic (Mason 2016). The H.K. government’s response to SARS was also marked by missteps, which left a considerable imprint on the city’s institutions and collective memory

(J.-W. Lee and McKibbin 2004). In contrast, the U.S. did not suffer as much from SARS, and the case was largely seen as a successful instance where the global health security apparatus successfully mobilized “the culture of negative asymmetry” to avert disaster (Cerulo 2008,

196). Furthermore, U.S. experts were wary of “overreacting” as the global health security apparatus system was accused of during the Swine Flu scare of 2009 (Lakoff 2015a: 313).

These collective memories result in a widely recognized concern of another SARS, which became a powerful resource for expert to raise attention to COVID-19. Despite of the turn to vigilance in the global community of public health experts, the same urgency, alongside fears and angers, are not shared by the public without past epidemic collective memory in the U.S., making an important analogy that has close cognitive distance with the public unavailable to vigilant experts in the U.S.

To activate appropriate responses to COVID-19, expertise needs resonate and be useful in addressing the concerns of the stakeholders. In China, bottom-up expert sentinel warnings that

attempted to invoke the SARS memory with the public activated state repression from local policymakers. Sentinel warnings of a SARS-like virus became resonant when it reached top- level policymakers who mobilized a robust response to contain COVID-19. SARS memory was only invoked with the public under a state-managed process. In H.K., experts were critical of policymakers which they saw as reluctant to act. Sentinel warnings of SARS coming back became resonant with the public that was also highly distrustful of the government, and civil society organizations mobilized to pressure policymakers to enact stricter anti-epidemic measures (see also Wan et al. 2020; Hartley and Jarvis 2020). In the U.S., different media outlets amplified a wide range of experts who mobilized a variety of sentinel and actuarial devices to understand COVID-19. This was exacerbated by political polarization as well as the

“crisis of expertise” and the “post-truth moment” (Eyal 2019; Fujimura and Holmes 2019;

Sismondo 2017). This led to the failure in creating a widespread resonance of expertise in the

U.S. during the initial months of the pandemic. The process of resonance is important across regime types.

3. Data and Methods

We focus on the initial responses to COVID-19, a time of uncertainty when actors were faced with many unknowns. Our case selection is based on a modified extreme case design

(Seawright 2016). It took H.K. four days between the first death and effective quarantine regulation, two weeks in China, and months for the U.S. yet largely on voluntary compliance.

We picked out China and the U.S. as they fall on opposite sides of the spectrum in responses.

H.K. was selected as a comparison due to its similarity to China in SARS encounters, but has been experiencing intense ongoing quest for democracy and distrust of government, which makes it a priori difficult to predict H.K.’s COVID response and presents us with an opportunity to investigate the key process behind each society’s search for solutions. It is

important to note that we are not comparing these cases in search of a set of underlying variables that can be generalized to explain response to COVID-19 in all societies. Rather, we examine the contingencies that enabled certain types of expertise to become resonant in critical moments and the processes where alliances with key stakeholders were created,

To trace how experts and expertise circulate and resonate at the initial stage of the pandemic in our three societies, we collected 12507 articles from six popular news sources in China

(Caixin [1597] and Global Times or GT [618]), H.K. (South China Morning Post or SCMP

[2101] and Apple Daily or AD [1452]), and U.S. (New York Times or NYT [6120] and Fox

News [619]) based on their contrasting ideological stances and target audiences. In China,

Caixin is a widely read news source that is known for its relative autonomy from the state, while GT is a newspaper that frequently takes a nationalist tone in its reporting and editorials.

In H.K., the SCMP is an English language newspaper that is read by the business community, while AD is a Chinese language tabloid newspaper known for its anti-establishment tendencies.

In the U.S., the NYT is a liberal leaning newspaper, while Fox is known for its conservative stance. Using media data for comparative analysis is common in studies of resonance

(McDonnell, Bail, and Tavory 2017), expertise (Eyal and Buchholz 2010), and have been applied for COVID-19 research (Chung et al 2021). We use a set of keywords to search the media articles that constitute our sample.1 We selected time periods that corresponded to the initial response of each society: when societies recognized COVID-19 was a problem to be confronted and settled on a public health intervention.2 Each author was in charge of the

1 Keywords we used include coronavirus (guanzhuang bingdu), Covid-19, pneumonia (feiyan), plague (wenyi), outbreak (yiqing), and pandemic (daliuxing).

2 For China, we selected the period from December 1 to February 1, one week after the Wuhan lockdown; for

H.K., we selected the period from December 31 to Feb 29, after mandatory quarantines were imposed on China and other major hot spots of COVID-19; and for the U.S., where there was no landmark of strict disease control

analysis of single case, and we relied on regular discussions over the course of Summer and

Fall 2020 to compare cases and articulate our theoretical framework. We conducted in-depth readings through our materials. We understand expert statements in the media to be a form of intervention aimed at swaying the public and policymakers (Eyal and Buchholz 2010). From there, we also collected social media postings, government reports, and transcripts that supplement our analysis.

4. Mainland China: Resonant Sentinel Warnings from the Top-down

Although the first COVID-19 case was detected in mid-December 2019 and evidence soon pointed to the potential for disaster, the Chinese government did not publicly recognize its severity until the late-January 2020. While institutions that were designed to identify and respond to outbreaks like COVID-19 failed due to the political pressure, Chinese experts strategically mobilized the contested memory of SARS as sentinel devices to resonate with different stakeholders with different consequences: Some experts directed their warnings at the public were met with repression; others tried to persuade policymakers, particularly those at higher levels, without necessarily alerting the public. This does not mean resonance with the public is not important. After public health experts and policymakers achieved consensus and decided to enforce contain COVID-19, they still needed public cooperation. This was accomplished through the state’s selective invocation of SARS collective memories. a. Failed Bottom-up Sentinel Warnings

In mid-December 2019, clinical evidence suggested that a SARS-like virus started spreading in Wuhan. Despite the implementation of protocols developed after the SARS epidemic, such as China’s Information System for Infectious Disease Control and Prevention

on the national level aside from social distancing guidelines issued in mid-March, we selected the period from

January 1 to April 30.

(CISDCP), their use was suppressed in the early days of COVID-19. During the December, doctors in Wuhan tried to report cases in CISDCP or notify the public yet were suppressed by hospital leaders and the local health authority. Records in CISDCP were either deleted or dismissed.3 Alongside problems in the CISDCP design such as overlapping disease categories in the reporting system (Wang et al. 2017), there is an important political reason for the malfunction of this existing reporting system: an infectious disease outbreak might paint the local government as incompetent and impact the political future of officials. Hospital leaders and local policymakers put social stability as the top priority, despite the rising worries about the new SARS.

Wuhan municipal and Hubei provincial authorities tried to repress the information about the new virus and its severity, while experts – mostly clinical doctors – had little leverage.

Doctors are managed by hospitals, which are governed by local health authorities. The local health authorities are under the supervision of two institutions: the central health authorities and local government. In practice, the latter often has more power, and in this case, decided to censor the information of a new virus.4 People who spread the warnings about the new virus were disciplined. On December 30, 2019, Li Wenliang, a doctor at Wuhan Central Hospital that later became known as the “whistleblower,” saw a test result that confirmed the existence of SARS-like cases and tried to warn his friends and colleagues. However, the connection between SARS and COVID-19 that Li and many other doctors with clinical expertise made did not automatically resonate with others in success. In contrast, reactivating SARS memories to the public without convincing the authorities first was considered to be problematic and may

3 信娜, 王小, 孙爱民, and 辛颖. 2020. “传染病网络直报系统投资了 7.3 亿，为何失灵了 28 天?” Caijing.

February 25, 2020; 萧辉, 包志明, and 高昱. 2020. “武汉疫情中的中南医院.” Caixin. April 12, 2020.

4 王端. 2020. “管轶：新冠肺炎发展曲线与 SARS 高度相似.” Caixin, January 20, 2020.

result in social panic and instability, which may impact the political career of local officials.

Li’s was admonished by the local police for “spreading rumor”, a common accusation in China when news unconfirmed by official sources arouses widespread public attention and indignation (Jiang 2016). Leaders of the Wuhan Central Hospital even forbade doctors to wear personal protective equipment (PPE), which latter caused a high casualty rate among doctors there.5 No news articles were published about the emerging virus while how people who spread rumors about SARS received punishment were circulated in the national media. Social media posts on related topics were limited and constantly censored (Lu, Pan, and Xu 2021), indicating these early attempts of warnings and resonance failed to reach the majority of the public.

On December 31, the Wuhan health authority finally released a statement, acknowledging the virus’s existence but still claiming it was preventable and controllable, downplaying its severity. Even after this, Chinese experts rarely appeared in the media before January 20, when the Chinese central government started to recognize the problem. Health authorities monopolized most of the information about the emerging pandemic. b. Making the Sentinel Warning Resonate with the Right Audiences

When the SARS-like cases were detected, not all Wuhan experts were alert and many failed to elicit an effective response from policymakers due to the political barrier. However, some experts skillfully sent out sentinel warnings to policymakers while taking concrete steps to safeguard healthcare workers. Wang Xinghuan, the head of Wuhan Zhongnan Hospital since

2015 who was a doctor in a Guangzhou hospital during SARS in 2003, was one of these rare exceptions. When Wang received evidence showing the similarity between the new virus and

SARS virus on January 2, 2020, “I felt something horrible was going to happen, SARS is

5 包志明, 覃建行, 高昱, and 萧辉. 2020. “李文亮所在医院为何医护人员伤亡惨重？.” Caixin. March 10,

2020.

back.”6 The combination of the virology evidence, his experiences of the SARS epidemic, and his tacit knowledge of Chinese politics pushed him to prepare for the terrible implications suggested by the SARS analogy and acted fast. Unlike Li Wenliang, Wang did not spread his concerns and speculations publicly. Instead, he mobilized the hospital to train employees, reorganized the hospital space, and prepared more medical equipment – all according to the potential needs of another SARS epidemic before the government sent out any signal.7

Wang also actively tried to mobilize local officials to ally with him by invoking some more targeted memories of SARS. He made a list of events in the 2003 SARS outbreak and sent them to government officials with a note saying that “the similarity is astonishing” in early

January to remind the authorities how devastating SARS was. He specifically highlighted the negative consequences for government officials who hid the SARS epidemic information: the mayor of Beijing and the minister of health were discharged due to their lax response. Wang aimed to ally with officials who wanted to preserve their political futures, although his efforts were not fully successful – the local authority still refused to draw the connection of the new virus to SARS. The best response Wang got from local government officials was a question

“Are things really that bad?” while others were warnings for him to not speak out. 8

Additionally, Wang tried to relay local epidemic information to national experts and the central government. When Zhong Nanshan and Li Lanjuan, experts in charge of the COVID-

19 investigation were sent down by the central government on January 18, Wang used his personal connections to reach out to Li Lanjuan and Zhong in their hotel to convince them of the similarity between SARS and the new virus. He went over the local authorities, who still

6 萧辉, 包志明, and 高昱. 2020.

7 徐炳楠, and 高翔. 2020. “多点战疫, 担当救治骑兵” Health News, March 30, 2020.

8 萧辉, 包志明, and 高昱. 2020.

wanted to downplay the problem and warned Wuhan experts to watch for their words. At that point, local authorities convinced two previous expert teams that the virus is preventable and controllable by pressuring local medical experts.

Compared to Li, Wang’s attempts to mobilize different actors without endangering himself while also successfully prepared his hospital for the upcoming pandemic demonstrated the allowed mechanisms in the existing system for expertise to cast an influence in the pandemic.

Even when the SARS memories found resonance among public health and clinical experts, they needed to carefully navigate the political landscape to avoid being classified as rumor spreaders and work within the political system to find ways to make the SARS analogy resonate with the political power. The collective memory of past disasters does not speak for itself and can be mobilized for different purposes. Different stakeholders struggled for the interpretation and mobilization of past disease memories, which became increasingly salient as the pandemic received national recognition after January 20, 2020. c. State Managed Resonance with the Public: SARS or Like-SARS?

The turning point of China’s response to the COVID-19 pandemic happened on January

20, 2020. The national expert team went back to Beijing that day and confirmed to the central authorities that the new virus could be a serious problem. Xi Jinping spoke about the outbreak for the first time, and Zhong was interviewed on national TV, stating that the virus is transmissible between humans. Once the central government acknowledged the problem, for a country with vivid past epidemic memory, actuarial devices were not needed to convince others.

In three days, social media posts about COVID-19 increased more than 100 times (Lu, Pan, and Xu 2021). The task now is to contain the outbreak and mobilize the appropriate public response, invoking the “ideal” SARS narrative to evoke vigilant responses without social panic or placing blame on the government.

Zhong Nanshan is a Guangzhou-based pulmonologist who made a reputation after the

SARS epidemic as a “SARS hero.” Zhong gained this reputation not only because he developed effective treatment for SARS, but most importantly, challenged public health officials over the severity of SARS epidemic and urged for more transparency at the beginning of the outbreak.

After SARS, Chinese central government and media framed his challenges as objections to corrupt local officials and honored him as a SARS hero. During the COVID-19 outbreak,

Zhong was considered as one of the most credible experts due to his SARS experience and was the most cited expert in the media.

SARS memories were strategically reactivated by Zhong in the media. In Zhong’s January

20 interview, SARS was highlighted. However, he carefully noted the differences between the novel coronavirus and SARS, trying not to embarrass the Wuhan authority for punishing doctors who claimed “SARS is back” in the early stage:

It is natural to connect the coronavirus with SARS. Yet the current coronavirus is

different from SARS […] It’s a virus of completely different nature […] Compared

with SARS, the infectivity is not so strong, and the toxicity is not so great.

At the same time, Zhong emphasized the uncertainty of the virus:

The infection with the new coronavirus has just begun and is still in the climbing stage.

As for what will happen in the future, the current case fatality rate cannot be

9 comprehensive, it depends on its development ... so we still must be vigilant.

Zhong’s carefully calibrated statement shows that when facing COVID-19, SARS memory must be addressed in China, even though it also refers to the government’s mishandling of

SARS. And yet his careful reference to the SARS memory left room for him and the authority to adjust their assessments. This “SARS-like but not SARS” reference was common among

9 陈宝成, and 赵今朝. 2020. “钟南山：新型冠状病毒肺炎肯定人传人.” Caixin, January 20, 2020

experts on media, who mostly had clinical backgrounds. This comparison meant to alert the public and policymakers, while preventing social panic and avoiding reminders of the government failure during SARS. After all, the multifaceted SARS collective memories could be both a facilitator and barrier for mobilizing ideal public resonance and response. On one hand, SARS memories represent how China can control the outbreak with intensive efforts, vigilance, and public collaboration. On the other hand, SARS memories are connected with how the Chinese government hid key information at the beginning and the devastation of society, which may cause dissatisfaction toward the government or social panic.

Emphasizing the former to mobilize the public without raising the latter aspect of SARS memories was a big challenge. This careful framing is salient in newspapers that are closed to the state, like GT. Although SARS was constantly mentioned, only how the Chinese government effectively controlled it, such as building Xiaotangshan Hospital in a week,10 was discussed in GT. Similar to Zhong’s “SARS-but-not-SARS” language, GT emphasized Zhong and other experts’ judgment on the virus’s relevantly weak toxicity and stressed that China today differs from the China during SARS. An editorial article published in late January argued that the government’s delayed response did not mean that it was “hiding something,” but the result of being “accurate and steady.” After all, China has “learned from the SARS experiences and has the capacity to control new diseases”.11 However, what were the lessons from SARS?

GT never explicitly stated them, as elaborating on what lessons learned would inevitably lead to the discussions of what mistakes made at first. Only when the Hubei provincial and Wuhan

10 李司坤, 陈青青, 万琳, and 李昊. 2020. “小汤山启用引发关注.” GT. March 17, 2020

11 环球时报. 2020. “防控好新型肺炎，让春节更祥和". GT, January 20, 2020.

municipal government leaders were discharged in February did GT implicitly mentioned similar governmental failure happened in SARS.12

However, critical media outlets and experts outside of China were more willing to make a direct comparison to SARS and to eschew the balance of expertise and politics that experts like

Zhong were bound by. Guan Yi, a virologist from the University of Hong Kong, explicitly drew a connection between COVID-19 and SARS in a January 20 interview with Caixin, not only about the virological similarities, but also how the government covered up information and the disastrous consequences. Guan’s warning became even stronger when he returned from a two- day Wuhan-trip on January 23, when, with his embodied SARS experience, he emotionally claimed that the upcoming pandemic will not be like SARS, but much worse than SARS:

Wuhan cannot control the outbreak… I can say that I have experienced a hundred

battles… But for this new coronavirus, I feel extremely powerless. There is no way to

compare it with the SARS epidemic... Most of them [previous diseases] were

controllable, but this time I am scared.13

Although different with Zhong’s balanced stand, Guan and Zhong’s comments were both on sentinel warnings without complicated models, as these sentinel arguments are enough to resonate society with a past disaster. Discourses allying with Zhong’s overwhelmingly surpassed Guan’s take of the COVID-19. However, the central government’s sudden accelerated move of the disease control showed that policymakers at the top seemed to be persuaded by this “more-than-SARS” warning. At midnight on January 23, Wuhan suddenly announced a strict lockdown. Seventeen cities in Hubei province followed two days later.

China’s powerful state machine was finally fully operating to combat the disease.

12 樊巍, 杨诚, 崔萌, 李珍, 青木, 叶蓝, 陈一, 王伟, and 柳玉鹏. 2020. “中国抗疫之战迎来新局面” GT.

February 14, 2020

13 王端, and 文思敏. 2020. “管轶：去过武汉请自我隔离.” Caixin, January 23, 2020.

5. Hong Kong: Sentinel Warnings Resonating with the Public

H.K.’s past experiences with SARS was crucial in its response to Covid-19. But sentinel warnings did not resonate with policymakers initially to activate the toolkits left by SARS, and experts openly criticized policymakers for not adopting stronger anti-epidemic measures.

Instead, expert warnings of a “SARS-like virus” that carried catastrophic implications resonated with the public that was already distrustful of policymakers and motivated parts of civil society, such as nurses and doctors unions, to go on strike to pressure policymakers to take on stronger policies to combat COVID-19. Policymakers eventually relented and heeded the advice of critical SARS experts, and imposed border restrictions and quarantines for new arrivals. a. Critical SARS Experts

The SARS Expert Committee Report completed in October 2003 with recommendations for future outbreaks was frequently cited by policymakers during the initial weeks of the

COVID-19 outbreak. Experts prominent in the media during COVID-19 were active during

SARS and were referred to as “SARS experts”. This is similar to the case in China, and in contrast with the diversity of experts in the U.S. Experts belonging to the H.K. government’s

COVID-19 expert advisory group formed on January 25 included Yuen Kwok-yung, David

Hui, Gabriel Leung, and Keiji Fukuda: Yuen was a microbiologist who helped identify the

SARS coronavirus; Hui was a clinician at the Prince of Wales Hospital, which was at the epicenter of the SARS outbreak; and Leung is a noted epidemiologist, who helped track the spread of SARS. Unlike the Chinese and U.S. cases, experts adopted critical stances publicly during the early phase of the outbreak. Despite their role as government advisors, these experts spoke out against what they perceived to be the policymaker’s slow and inadequate response.

These experts advocated measures that they perceived to have helped during SARS. Their advice includes wearing masks, setting up quarantine facilities, retrofitting isolation wards in

public hospitals, and border health checks. Ho Pak-leung, a microbiologist at the University of

Hong Kong, was an early proponent of mask usage as early as January 9:

“The public should wear disposable surgical masks in crowded places,” Ho said. “They

should also clean their hands frequently.” He added it was important to take note of good

toilet hygiene, as according to past experiences in SARS and MERS, infected patients’

urine and feces could carry lots of coronaviruses that could be spread to others.14

These warnings were given ahead of guidance issued by U.S.-based experts, who were still waiting for evidence in support of these precautionary measures. The SARS experts therefore did not simply draw on established science to guide their advice to policymakers and the public, but rather, relied on the experience of combatting SARS to help contain COVID-19. b. Sentinel Warnings of a SARS-like Virus

Even though H.K. policymakers initiated several measures to monitor the potential import and spread of the novel coronavirus, these critical experts continued to push for stronger measures. When news of cases of “pneumonia of unknown origins” broke in late December

2019, H.K. experts compared the mystery illness to SARS. While H.K. policymakers activated the “serious response level” on January 4, policymakers faced criticism for doing too little.

H.K. policymakers came to know about the COVID-19 outbreak in Wuhan through these experts. In an interview, Yuen recounted the role of informal information sharing with contacts in China:

On Dec 31, 2019, I heard from some mainland researchers that a new virus had emerged,

and it was suspected to be a SARS-like virus. It sounded like trouble. I notified the [H.K.]

government as soon as I got the word. […] By the evening, the Hong Kong government

had already convened a small group of experts, after which the Department of Health asked

14 Cheung, Elizabeth. 2020. “Wuhan Pneumonia: What We Know about the New Virus and How You Can Stop

Yourself Getting Sick.” SCMP, January 9, 2020.

the hospital authorities, customs and family doctors to step up health surveillance with a

raft of measures. We did not know how serious the virus was at that time, nor did we know

it was a new type of coronavirus, but because the virus appeared in the winter season and

we were told it was related to SARS, we decided to be very cautious, and the Hong Kong

government took our opinions seriously.15

While policymakers heeded Yuen’s initial warning, Yuen and other critical experts would come to criticize the policymakers for not doing enough to prevent a local outbreak. Reports in early January also latched onto the finding that the new virus was “80 percent the same as

SARS,” stressing the need to be vigilant.16 While the warnings did not achieve the level of resonance that was desired with policymakers, the analogy of COVID-19 to SARS and its implications for taking stricter public health measures resonated with the media. Yuen mobilized this comparison with SARS in warning the public, in remarks to the media on

January 21:

Now we can see infections of family members and in hospitals. What we are worried most

about is a large outbreak in the community that may cause a situation like what we

experienced during SARS... We are worried that the super-spreading event might have

occurred already… we need to see if sustained human-to-human transmission has

happened.17

The potential for super-spreader events and community spread was echoed by other experts in the media during this early period. The massive flow of people accompanied with the

15 Li, Isabelle, and Zuoyan Zhao. 2020. “Q&A with HK Microbiologist Yuen Kwok-Yung Who Helped Confirm

Coronavirus’ Human Spread.” The Straits Times, March 10, 2020.

16 AD. 2020. “基因圖譜網上曝光武漢肺炎首宗死亡病毒八成似沙士.” AD, January 12, 2020.

17 Cheung, Elizabeth. 2020. “Wuhan Virus a Step Closer to Full-Blown Epidemic, Expert Warns.” SCMP, January

21, 2020.

Chinese New Year festivities at the end of January further exacerbated the worry of experts that those returning to or arriving from China would import cases of the mystery illness.

Other experts also openly criticized policymakers. Hui urged the government to step up checks at the border and to punish those who lie on health declaration forms. Ho, the outspoken microbiologist, on January 23 sounded the warning in stark terms: “Hong Kong needs to wake up. We all need to wake up. The situation right now is very severe.” 18 Leung, the epidemiologist, was later interviewed on a local radio show on February 5, and was heavily critical of the indecisiveness of policymakers and the half-baked measures that they had rolled out thus far:

Was it too late? If we are closing down the checkpoints, we should have done that in early

January… The best public health measures should be rolled out in one go, rather than being

announced in stages, especially when the stages were just days apart…. Can we have

stronger measures to contain the disease? The health declaration was done on an honor

system, but was it enough?... Some medical experts are pessimistic, they think all we can

do is just mitigate the situation, not to roll out measures to contain it… I am not sure

whether we are in the mitigation or containment stage, but I know we are not in an early

containment stage.19

These criticisms on the government’s disease containment efforts resonated with a public that was already skeptical of the H.K. government and the Mainland authorities (see also Wan et al. 2020; Hartley and Jarvis 2020). This mistrust is rooted in their mishandling of SARS in

18 Siu, Phila. 2020. “China Coronavirus: Hong Kong Officials ‘Not Doing Enough to Stop Spread.’” SCMP,

January 23, 2020.

19 Cheung, Tony, and Gary Cheung. 2020. “Coronavirus: Quarantine for All Arriving in Hong Kong from

Mainland China.” SCMP, February 5, 2020.

2003, the perceived deference of the H.K. government to Mainland authorities, as well as the political upheavals in H.K. in 2019 over the Extradition Law Amendment Bill.

Distrust in Chinese authorities manifested itself in models and actuarial devices aimed at estimating the disease spread within China, rather than projections of future spread in H.K..

Leung, the epidemiologist, estimated on January 27 that there were some 25,630 symptomatic patients in Wuhan and that the number would double in 6.2 days. This was in contrast to numbers put out by the Mainland authorities, which announced that the number of confirmed cases across the country was 2,800. Leung did not mince words:

We have to be prepared, that this particular epidemic may be about to become a global

epidemic…. Substantial, draconian measures limiting population mobility should be taken

immediately… So, the question is not whether or not to do more… The question really is,

how can we make sure that it is feasible, implementable and enforceable.20

The use of these models had two effects. First, Leung’s model showed the need for early intervention if H.K. did not want to see a massive outbreak. Second, the contrast between

Leung’s numbers and official numbers coming out of Wuhan and Beijing would exacerbated public distrust of the Mainland authorities. c. Resonance from the Bottom-Up: Mobilizing Civil Society

These warnings from H.K.’s critical experts resonated with the public. Reporting in AD— an outlet known for its criticism of the H.K. and Chinese governments—was largely skeptical of information from Chinese officials and experts, stoking fears and anxiety about a SARS- like cover up amongst the public.21 Reporting in early January in AD was often in the genre of undercover reporting, where journalists showed up in Wuhan in hopes of probing hospital

20 Ting, Victor. 2020. “‘Draconian Measures’ Urged as Research Estimates 44,000 Virus Cases in Wuhan.”

SCMP, January 27, 2020.

21 For example, AD. 2020. “全城恐慌瘋搶口罩板藍根.”AD, January 2, 2020.

workers, train station staff, and pharmacists about the “actual situation.”22 Rumors on Chinese social medias were also cited in these news reports, and warnings about not to repeat the mistake 17 years ago of trusting Mainland authorities were commonplace.23 A January 3 AD report described H.K. residents looking for surgical and N-95 masks only to find that pharmacies had increased prices by over 30% and that some pharmacies had sold out of medical masks.24 A January 7 SCMP report also described panic buying of face masks and price gouging, because of widespread anxieties amongst the public of an impending outbreak in the city. 25 Resonating with the widespread public distrust and perceptions that the local government to be too afraid to contradict Chinese authorities.

Professional organizations and unions took a leading role in exerting pressure on policymakers. Unlike similar groups in China that faced consequences for speaking out and weakened unions in the U.S., these professional groups held sway over the provision of key public goods and services necessary in combating the epidemic. During SARS, the city’s medical staff were unprepared to deal with the infectious disease, with many succumbing to

SARS. Eager to prevent history from repeating itself, doctors and nurses, largely from the

Hospital Authority’s public hospitals, organized quickly. Alfred Wong, a spokesman for a political advocacy organization in the medical sector Medecins Inspires, was quoted as saying on January 19 in SCMP, that H.K. needed to “stand firm and demand more information from

22 AD. 2020. “春運旅客塞爆車站零防疫少人戴口罩.” AD, January 11, 2020.

23 AD. 2020. “武漢個案急增當局稱情況「可控」深圳嚴陣收 17 疑似染疫者.” AD, January 20, 2020.

24 AD. 2020. “市民撲口罩部份藥房斷貨.” AD, January 3, 2020.

25 Zhang, Karen. 2020. “Hong Kong’s N95 Stocks Low amid Wuhan Mystery Virus Fears.” SCMP, January 7,

2020.

China… This is a key period for H.K. to prevent the spread.26 Even the U.S. a whole ocean away requires travelers from Wuhan to fill out health declarations. H.K. should have higher contact with Mainland authorities, we should be more well prepared.” Thousands of medical staff represented by the newly formed Hospital Authority Employees Alliance in H.K. would go on a 5 day “anti-epidemic strike” in early February, demanding the government close the city’s borders and supply more PPE. Carrie Lam, H.K.’s Chief Executive, ruled out the proposals by labor unions to close the border, calling this “inappropriate and impractical”.27

Other allied unions, such as the Flight Attendants’ Union representing Cathay Pacific air stewards, echoed the concerns of medical staff and also called for their company to halt flights to and from China, threatening to strike on February 2. On February 4, Cathay Pacific responded to these concerns and announced that it would cut 90% of its China services, while also modifying in flight service protocols to reduce the risk of on-board transmission. This category of lay and professional experts who had outsider knowledge on the potential impact of an epidemic was featured prominently in news coverage during the end of January and beginning of February.

Existing political anger propelled the wider public to find resonance in more drastic measures aside from unions and workplace actions. Parents United, a concern group pressuring the government to suspend classes, noted that many parents were “frustrated by the bureau’s

‘slow response’ to the outbreak.” 28 Eventually, Sophia Chan, H.K.’s Health Secretary,

26 Low, Zoe. 2020. “China Coronavirus: Hong Kong Urged to Step up Measures as New Cases Suspected.”

SCMP, January 19, 2020.

27 Lum, Alvin. 2020. “Hong Kong leader adopts advice from medical experts – but draws line at closing border with mainland China.” SCMP, January 25, 2020.

28 Chan, Ho-him. 2020. “Pressure Mounts on Education Bureau to Suspend Classes after Holiday.” SCMP,

January 24, 2020.

admitted that existing bans on Hubei travelers was “not 100 per cent effective” and that the government was considering more drastic action, but needed to consult with the Mainland authorities before implementing border closures. 29 More radical action was pursued by protesters, such as burning objects and throwing debris into the East Rail line, which connects

Kowloon to the Shenzhen border. 30 Explosive devices were also detonated at the Caritas

Medical Center in Cheung Sha Wan, and a message from the perpetrators was posted anonymously on Telegram, saying “We will act on our word. Go on strike immediately if you don’t want to die. We will take more actions to call for the closing of borders.”31 It is unclear how these extreme actions factored into the thinking of policymakers. Nonetheless, the pressure from professional organizations and unions helped convince policymakers in H.K. to adopt stricter border checks and quarantine measures for new arrivals in the city by mid-

February. The resonance of sentinel warnings with the public played a critical role in shaping

H.K.’s response to Covid-19.

6. United States: Diversified Warnings, Diversified Resonance

The U.S. case stands out from China and H.K. due to the high degree of political polarization. Furthermore, without the experience of a recent disastrous disease, past disease memories in other countries could not serve as a powerful warning for the U.S. public. As

COVID-19 entered the U.S., there was no dominant consensus regarding its implications

29 Chan, Ho-him. 2020. “H.K. health minister admits Hubei entry ban ‘not 100% effective’, ahead of meeting to discuss new measures against contagion.” SCMP, January 27, 2020.

30 Leung, Kanis. 2020. “Hong Kong Protesters Disrupt Railway, Declare ‘Dawn of Anti-Epidemic’ Action.”

SCMP, January 29, 2020.

31 Cheung, Tony, and Christy Leung. 2020. “Police Suspect Hospital Bomb Linked to Hong Kong Protests.”

SCMP, January 27, 2020.

among public health experts, leading to the contested use of sentinel and actuarial devices.

Even when severe consequences were almost certain, the lack of an obvious analogy led to the reliance on modeling and future predictions. The diversity of pandemic experts opened the door to selective mobilization of expertise that resonated differently with actors located in various positions on the political spectrum. Although sentinel warnings were raised by experts in the U.S. at different times, this form of expertise failed to achieve widespread resonance.

a. Diversified Resonance Under Different Political Interests

Messages from public health experts achieved different levels of resonance with actors in various positions on the political spectrum, and political actors enlisted different experts to advance their political positions. Important discrepancies in media coverage only appeared after the strict measures like quarantine and travel restrictions against China were set in place in late January. Public health experts did not dispute the necessity of these measures at the time and mobilized sentinel warnings. Nancy Messonnier, director of the National Center for

Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention

(hereby CDC), when justifying the first federal quarantine order in 50 years, said “While we recognize this is an unprecedented action, we are facing an unprecedented health threat.”32

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, also highlighted uncertainty when justifying the precautionary actions taken in late January, “Unlike influenza, which is fairly predictable in terms of infection and mortality… there was not the same certainty about the rate and path of the coronavirus transmission”33.

32 Rabin, Roni Caryn Rabin and Denise Grady. 2020. “195 Quarantined in California After Fleeing Coronavirus

Epicenter”. NYT, January 31, 2020.

33 Michael Corkery and Annie Karni. 2020. “Trump Administration Restricts Entry Into U.S. From China”. NYT,

January 31, 2020.

These sentinel warnings achieved different levels of resonance across media outlets.

Amongst conservative commentators, the strict measures fit well with preexisting antagonistic sentiments against China, and served as a diversion from the impeachment of then President

Trump. In late January, Fox News often featured “China hawks” and Republican Senators known for mistrust of the Chinese government. These commentators described China as on the

“brink of a real disorder”34 and leaned towards strict measures to prevent the spread of Covid-

19 to the U.S. During an interview, Republican Senator Tom Cotton suggested stopping air travel from China, stating that: “I suspect that months from now… when people look back at this time, coronavirus will be considered the bigger story than impeachment.”35 Fox hosts suggested that the new virus could be worse than SARS, due to the two week incubation period, and compared the pandemic potential of Covid-19 to the Spanish flu36. There was no sign of dismissing public health experts as being overly cautius among Fox hosts at this early stage.

Before the travel ban was announced in late January, Fox host Hannity invited Fauci to join his show to discuss the severity of cases in China and highly praised Fauci’s expertise, “I’ve watched you over many decades and I know this is your wheelhouse”37. Yet, the vigilant attitude was directed to countries other than the U.S. While the virus was described as causing terrible consequences in China and other “weak health systems”, for the U.S., “the flu… is a

34 Fox. 2020. Fox News Channel: Tucker Carlson Tonight. February 3, 2020.

35 Fox. 2020. Tucker Carlson Tonight. January 27 2020.

36 Some examples: January 29, Fox News: The Five; January 28, Fox News: The Five; January 28, Tucker Carlson

Tonight.

37 Fox. 2020. Hannity, January 27 2020.

much bigger threat than coronavirus” according to a physician commonly interviewed on Fox and Fox correspondent38.

NYT took on a different tone that formed stark contrast to Fox News. As a prestigious liberal media outlet, NYT highlighted issues such as human rights and xenophobia. While NYT also reported the cover-up of Chinese government and the severity of the pandemic in China, the

NYT also reported on the racism and xenophobia experienced by the Chinese diaspora early on39 and also warned in opinion pieces against Trump’s xenophobic instinct to overreact40.

Additionally, NYT opinion pieces featured psychologists warning against irrational instincts to overreact. It was argued that influenza is more serious than COVID-19, although without the

American-exceptionalism in the Fox argument:

The virus had killed about 1,100 worldwide and infected around a dozen in the United

States… but a much more common illness, influenza, kills about 400,000 people every

year… the metrics of public health might put the flu alongside or even ahead of the new

coronavirus for sheer deadliness… there is a lesson, psychologists and public health experts

say… it illustrates the unconscious biases in how human beings think about risk.41

38 Fox. 2020. Tucker Carlson Tonight. January 30 2020. Other examples: Fox. 2020. Fox News: Your

World with Neil Cavuto. January 28 2020.

39 Joseph Goldstein and Jeffrey E. Singer. 2020. “Coronavirus in New York: Lunar New Year Events Canceled

Over Fears” NYT. January 29, 2020. Motoko Rich. 2020. “As Coronavirus Spreads, So Does Anti-Chinese

Sentiment” NYT. January 31. James Barron. 2020. “Coronavirus in N.Y.Without Chinese Tourists, Business

Sags”. NYT. February 4, 2020.

40 Crowley, Michael. 2020. “Health Experts Worry Trump May Overreact to Epidemic.” NYT. February 11, 2020.

41 Fisher, Max. 2020. “Coronavirus ‘Hits All the Hot Buttons’ for How We Misjudge Risk.” NYT, February 13,

2020.

An editorial by another psychologist made a similar argument that the fear stoked by the virus toll would make people “more susceptible to embracing fake claims.”42 A journalist from a travel industry news company, an industry that had an interest in maintaining borders open with China, wrote an opinions piece titled “Who Says It’s Not Safe to Travel to China?”, arguing against the travel ban and described the motivation behind it as “doesn’t appear to be evidence”43. It should be noted that most of NYT’s news reports attempted to present a “balance” of differing expert opinions, and thus featured both the actuarial and sentinel expertise. The argument that COVID-19 would become a pandemic and spread like H1N1 was raised as early as February 244. However, a significant amount of opinion articles written by a wide range of experts, including physicians, frequent NYT contributors, and psychologists, published in this period leaned towards an actuarial stance, and even when articles argued for caution, they usually highlighted the importance of keeping calm, washing hands and expressed reservation towards face masks, in other words, not deviating much from life as usual45.

In summary, although in the very early period both NYT and Fox News deferred to the experts, Fox News was more supportive of a sentinel attitude while NYT leaned towards an actuarial attitude, both of which resonated with the existing political interests of the medias.

The sides would soon change.

42 DeSteno, David. 2020. “Coronavirus Fear.” NYT, February 11, 2020.

43 Spinks, Rosie. 2020. “Who Says It’s Not Safe to Travel to China?” NYT. February 5, 2020.

44 McNeil Jr., Donald G. “Wuhan Coronavirus Looks Increasingly Like a Pandemic, Experts Say” NYT. February

2, 2020.

45 Farhad Manjoo. 2020. “Beware the Pandemic Panic” NYT. January 29, 2020; Elisabeth Rosenthal.2020.“How to Avoid the Coronavirus? Wash Your Hands” NYT. January 30th,2020. Knvul Sheikh, Derek Watkins, Jin Wu and Mika Gröndahl. 2020.“How Bad Will the Crisis Get?”NYT. February 2, 2020; Aaron Carroll. 2020. “Health

Lessons That Go Beyond the Coronavirus Epidemic” NYT. February 11, 2020.

b. Making the Serious Warnings Resonant: It’s Like A Bad Flu

The debates of expertise became more public and dramatic as the virus began to spread in the U.S. With no lived memories of past catastrophes available, the task of making strict public health measures acceptable to the public became more difficult. SARS was invoked by U.S. experts and media outlets, but this comparison did not resonate with the public. In late January

Fauci devoted an article comparing SARS-COV-2 with SARS-COV and MERS in a professional journal (Paules, Marston, and Fauci 2020). In the early presentations of COVID-

19 in the U.S. media, when COVID-19 was largely outside of the U.S., SARS was mentioned quite often by both Fox and NYT. However, when concerning the U.S., economic expert Larry

Kudlow described that like SARS, COVID-19 is a “Chinese pandemic” unlikely to impact the

U.S. economy46. This sentiment was shared by Marc Siegel, a physician and a Fox News contributor, describing flu as more worrisome than the new coronavirus in the U.S. 47Although

NYT did not share the American exceptionalism sentiment, in this early period, SARS was sometimes presented as a positive example that “SARS-like scare” could turn out to be a “blip in epidemic history.”48

The sacrifices made and horror experienced in China and H.K. during SARS to make the elimination of SARS possible was not part of the U.S. experience. There were no obvious implications regarding the pending community spread of a new coronavirus in the U.S. The experts mobilizing different forms of expertise provided various interpretations for what it

46 Fox. 2020. Live Event. January 29, 2020.

47 Fox News Channel: Tucker Carlson Tonight. January 29, 2020.

48 Dan Werb, “To Understand the Wuhan Coronavirus, Look to the Epidemic Triangle”. NYT. January 30, 2020.

Denise Grady. 2020. “As Coronavirus Explodes in China, Countries Struggle to Control Its Spread”. NYT.

January 31, 2020. Farhad Manhoo, “Beware the Pandemic Panic”.NYT. Jan 29,2020. Fox.2020. Live Event,

January 29, 2020.

would mean to the U.S.. Similar to the previous stage, this difference would be picked up and amplified by the media outlets on different sides of the political spectrum. However, the media stance regarding sentinel and actuarial devices switched as the Trump administration leaned towards an actuarial approach once the pandemic had spread widely within the U.S..

On February 25, Messonnier issued a sentinel warning that community spread of COVID-

19 was almost certain, proposing measures like social distancing, closing schools, and working from home.49 While the NYT article covering Messonnier’s statements was sympathetic to her general judgement, there was no reference to past catastrophic disease memories. Although

Anne Schuchat, principal deputy director of the CDC, agreed with this judgment, she compared the expectations to a bad flu year and the 2009 swine flu, “I think to help Americans frame what to expect, it’s helpful to think about a bad flu year, or even the 2009 pandemic”.50 She also appeared during Fox News’ coverage of White House briefings, saying that the coronavirus “spreads in a similar way to the common cold or to influenza… everyday sensible measures that we tell people to do every year with the flu are important.. not very exciting measures. but really important…”51. In the White House press briefing covered by Fox, flu had

7 mentions whereas SARS had no mention. The implications of this comparison were drastically different from the catastrophic comparisons to SARS that the Chinese and H.K. public were exposed to.

Interpretations of these sentinel warnings differed drastically even amongst commentators within the same media outlet. On February 25, after quoting the stern warning of Messonnier,

49 Belluck, Pam, and Noah Weiland. 2020. “C.D.C. Officials Warn of Coronavirus Outbreaks in the U.S.” NYT,

February 25, 2020.

50 Rev. 2020. “Transcript: U.S. Health Officials on Response to Coronavirus February 25, 2020.” Rev. February

25, 2020.

51 Fox. 2020. Fox News: Special Report with Brett Baier. February 26, 2020.

Fox host Carlson cited a Harvard epidemiologist that predicted the coronavirus as likely uncontainable and went on to criticize that “America is not ready for this or for any major epidemic… Thanks to the CDC’s flawed rollout of coronavirus testing”.52 However, on the

Ingraham Show in Fox News, after showing a clip of Messonnier’s warning, they immediately shifted to expressing cynicism over China’s disease control without discussing Messonnier’s message at all. Fox News also interviewed Fauci on the same day. While Fauci was optimistic that the virus “has been contained very successfully” in the U.S., he also stressed the unknown, saying that “the chances of there being spillover into our country… a pandemic… you have to prepare for it.”53. However, the conclusion that Fox host Baier drew was, “Do what you always do” 54 . The voice of the experts was selectively emphasized and the sentinel warning downplayed. Meanwhile, forming a contrast with Fox News, NYT highlighted the sentinel warning by heavily covering Messonnier’s message at the beginning of one article, mentioning

Fauci at the bottom as “other federal health officials were trying to tamp down concerns”55.

The consequences of a highly contagious new coronavirus about to spread in the communities was open to contending interpretations that differed between sentinel and actuarial leanings. Without a vivid lived experience of past disasters, the sentinel warnings did not achieve widespread common resonance in the U.S. as it did in China and H.K. Expert statements could be selectively mobilized for political purposes: which aspect of the experts’ voice got to represent the future was intermingled conveniently with political concerns. Even

52 Fox News, Tucker Carlson Tonight, February 25, 2020.

53 Fox. 2020. Special Report with Brett Baier, February 25 2020.

54 Fox. 2020. Fox News: Special Report with Brett Baier. February 25 2020.

55 Belluck, Pam, and Noah Weiland. “It 'Could be Bad': Viral Crisis in U.S. is Deemed Likely”. NYT. February

26, 2020.

when experts expressed uncertainty, the analogies and interpretations referring to a not-so- scary past is available, and could lead to the conclusion of life as usual. c. Diversified Resonance Take Two: Contesting Validity of Models

Even as the opinions of public health officials converged, with no immediate catastrophic past to draw on, experts with sentinel warnings had difficulty developing a resonant frame that is close to the experiences of the public and had to resort to future predictions. However, the resonance of future predictions based on models could be easily contended as commentators undermine the authority of experts producing the models drawing on other expertise.

In late February, predictions of the pandemic’s course by public health experts increasingly converged. In mid-March, NYT reported Fauci warning people to “hunker down significantly more than we as a country are doing.”56 This statement was preceded by his statement on March

10 to flatten the curve, as the gentler curve results in fewer deaths. However, while public health expert opinions converge, the search for a resonant message to convey the consensus had much less success. Hope was increasingly placed on predictions generated by models. And yet, in late February, while reports on CDC internal modelling began to appear on the media, showing drastic projections of how the virus could spread in the worst-case scenario in which no actions were taken and the projections of the spread of virus under different intervention measures, NYT reported that CDC had not yet provided any public official projections of the virus.57 Although the experts interviewed explained that they did not disclose the modelling result because overdoing leads to panic while the opposite leads to complacency, the same article highlighted the importance of expert predictions in motivating Americans to adopt even stricter measures to mitigate the spread of the virus:

56 Padilla, Mariel, and Zach Montague. 2020. “Nunes Encourages People to Dine Out as Experts Urge Them to

Stay Home.” NYT, March 15, 2020.

57 Fink, Sheri. 2020. “Worst-Case Estimates for U.S. Coronavirus Deaths.” NYT, March 13, 2020.

Without an understanding of how the nation's top experts believe the virus could ravage

the country, and what measures could slow it, it remains unclear how far Americans will

go in adopting – or accepting – socially disruptive steps that could also avert deaths. And

how quickly they will act.

However, future predictions are imagined scenarios that are distant from people’s lived experience and are fragile and open to debate. That is not to say that future predictions can never work as resonant expertise, but when future predictions have been politicized and sides are drawn, political actors would attack the experts who did not provide predictions that they wanted.

Worrying signs emerged in late February after Messonnier’s warning. Many Fox shows started to connect strict disease control measures with Democrats’ attempt to politicize the pandemic and use it against Trump58. Fox host Tucker Carlson, who was initially very alert to the development of the pandemic, flipped his judgment as criticisms against the Trump administration’s handling of the pandemic amassed. Following a stock market slam on April 3 triggered by a bad unemployment report and Trump repeatedly stating “We have to open out country again”59, Carlson used the actuarial stance that Fauci took in the early days of the pandemic against him, undermining Fauci’s demand to take even more drastic measures. He quoted what Fauci said in the early days that “people ought to worry more about ‘the real and present danger of the annual flu’ than about coronavirus.”60 Carlson made the argument that

58 Fox. 2020. The Story with Martha MacCallum. February 26, 2020; Fox. 2020. The Story with Martha

MacCallum. February 28, 2020.

59 Donald Trump, Donald Trump Coronavirus Task Force Transcript April 4. https://www.rev.com/blog/transcripts/donald-trump-coronavirus-task-force-transcript-april-4 Accessed May 13,

2021.

60 Fox. 2020. Tucker Carlson Tonight, April 04, 2020.

NYT was making two months ago, that “Human beings frequently underestimate risk, particularly risk on the horizon. Then they very often in turn overreact to risk once they identify it.” He further argued that the models that medical experts relied on to predict the hospital beds have been wrong by large margins, much fewer beds are needed than predicted in reality, placing the argument that slowing the curve can prevent overwhelming hospital resources in doubt. Enlisting expertise, the same reasoning can serve different political purposes at different timepoints. When experts’ current advice goes against the current political interests of the media, their previous history can be used against them to undermine their authority. More evident attacks on the credibility of experts were also launched. In April, the National Institutes of Health experts were described on Fox News as “working with China. They didn’t want to get China upset,” which would “bury many Americans because of this.”61

NYT, on the other hand, increasingly published dire projections based on modelling. On

March 13th, NYT began publishing articles of non-CDC experts modelling the growth of cases, especially emphasizing the exponential growth capacity of COVID-19. 62 After Trump suggested opening the country soon on March 23, NYT teamed up with epidemiologists on

March 25 to create model predictions of what the curve would look like if the reopening happened too soon.63

Like H.K. and China, disease control devices became politicized in the U.S. However, unlike H.K. and China, there was no lived memories of catastrophic past diseases that can easily resonate with the public. The implications of a novel pandemic relied upon the

61 Fox. 2020. Tucker Carlson Tonight, April 15, 2020.

62 Roberts, Siobhan. 2020. “The Exponential Power of Now.” NYT, March 13, 2020.

63 Kristof, Nicholas, and Stuart A. Thompson. 2020. “Trump Wants to ‘Reopen America.’ Here’s What Happens

If We Do.” NYT, March 25, 2020.

demonstration of the future through modeling, which became easily contended as media outlets drew on diverse expertise to criticize the experts behind the models.

7. Conclusion

Our study explored different expertise and the different ways in which resonant expertise was achieved in China, H.K., and the U.S. during the initial stage of COVID-19 (Table 1).

Through these case comparisons, we demonstrated that the process of expertise gaining resonance was critical in enabling state and society to recognize the threat of COVID-19 and devise strategies to counter the outbreak.

Table 1: Resonant Expertise Mainland China Hong Kong United States Leading SARS experts (and SARS experts Debates between Experts heroes) experts Dominant Sentinel devices: Sentinel devices: Mixed sentinel and Expertise Reactivating the Reports of SARS-like actuarial devices: SARS memories in disease in Mainland Debates between different ways China + estimates of public health experts spread in Mainland and the politicization China as sentinel of public health warnings experts by other experts Policymakers Resonance achieved: Policymakers heeded Resonance not First ignored and advice of experts, albeit achieved: Fractured repressed by local slowly, and were response; veering policymakers; strict criticized for reluctance from anti-science to lockdown once to close the borders neglect sentinel warnings resonated with central policymakers Public Complied with Resonance achieved: Resonance not directives from public distrust of achieved: Critical of policymakers; policymakers and experts and models; collective memories critical of weak lack of recent of past epidemic response; collective memories of severe memories of past infectious diseases epidemic

We showed in our analysis how past experiences with disease, approach of expertise, in conjunction with the political orientations of different actors shaped the approach to COVID-

19 in different societies. The different invocations of the past enabled different types of resonance to emerge. Both China and H.K. experts relied on sentinel devices and SARS collective memories, highlighting the uncertainty of the new virus and potential devastating consequences it might cause. They went through different pathways to ally with the key stakeholders in their societies and contribute to more effective responses to the crisis. The slow and ineffective response of the U.S., especially when compared to H,K., can be attributed to not just the anti-science orientation of political leaders, but also to the ways in which sentinel and actuarial expertise was debated by the public with different political interests. Resonant expertise was particularly difficult amidst political polarization.

While such examples of resonant expertise detailed in our study is highly contingent and context dependent, the process of expertise gaining resonance is crucial in shaping COVID-19 responses in other countries. There were societies where policymakers and publics heeded the advice experts who advocated for strong measures of quarantine and social distancing, based on past experience with disease outbreaks such as SARS and MERS, such as with South Korea,

Singapore, and Taiwan. The fractured expert field and the lack of resonance of expertise observed in the U.S. can also, to a certain degree, be seen in the United Kingdom, which only reluctantly imposed harsher measures when projections showed an exponential increase in cases. However, there were also countries where past experience with disease was not as apparent. In these cases, local experts had to do double the work to convince policymakers and the public that harsh measures were needed, such as in New Zealand. Additionally, as we demonstrate in our study, it is not enough that policymakers and the public “listen to the science,” as seen in the case of Sweden, which pursued a limited mitigation strategy that is often described as aiming to produce “herd immunity”, on the advice of a small segment of

local experts. The content of expertise, which is also associated with one society’s past experience and current contingencies, matters too.

There are necessarily limitations to our study. Cross-case comparisons often ignore sequence effects. How different societies respond to COVID-19 is not independent from how others respond. The China- H.K. are also not fully separate societies, although anti-Beijing sentiments in H.K. remains high. Our comparisons sacrifice detail and analysis of within-case variation in order to elicit dynamics that are comparable across cases. Another limitation is our reliance on media reports, but we have made efforts to triangulate and trace the documentary trail across a variety of sources. This was limited by the challenges of conducting fieldwork during the crisis. Our observations are exploratory. Future work should make use of archival access, interviews, and observations of how various forms of expertise influenced decision making in key organizations.

These findings have several implications for the management of future crises and for public health. First, given the variety of experts and expertise identified by the media as relevant to

COVID-19, there needs to be more reflexivity in the process of deciding what is legitimate and illegitimate forms of knowledge. Both over-centralization and -diversification of the public experts could be problematic, as China's repression on experts and the U.S.’s inaction and confusion indicated. Second, the relevant experience of SARS that served China and H.K. well should have also informed the responses of the U.S. and elsewhere. As commentators have noted, there were information gaps and lags, where headlines and scientific findings common in China were repeated weeks and months later in the U.S. (Yang 2020). This points to a certain unevenness in the global field of science and public health that privileges statements from elite and dominant scientists. As a community of inquiry, scientists engaged in public health should pay attention to marginal and peripheral voices and consider ways in which hard-to-codify experiential knowledge can be shared.

The expertise field and the claims based on past memory are never homogeneous but are constantly contested. The struggles of the expertise and the past during the COVID-19 will not stop when the pandemic is over. While the pandemic rages on, we already saw battles over how we should remember COVID-19. The Chinese government, for example, published an

“official history” of the COVID-19 to institutionalize “correct collective memories” and suppress recollections of the information repression and the delayed response in the early stage.

Similar attempts can be observed during the Trump administration in the U.S. too. Sociological research must play a role in documenting and analyzing these struggles over the past and challenging the claims of different powerful actors.

References

Carduff, Carlo. 2015. The Pandemic Perhaps. UC Press.

Cerulo, Karen A. 2002. Culture in Mind: Toward a Sociology of Culture and Cognition.

Psychology Press.

Chung, Angie Y., Hyerim Jo, Ji-won Lee, and Fan Yang. 2021. “COVID-19 and the Political

Framing of China, Nationalism, and Borders in the U.S. and South Korean News

Media.” Sociological Perspectives 07311214211005484.

Eyal, Gil. 2019. The Crisis of Expertise. Cambridge, UK ; Medford, MA: Polity.

Eyal, Gil, and Larissa Buchholz. 2010. “From the Sociology of Intellectuals to the Sociology

of Interventions.” Annual Review of Sociology 36 (1): 117–37.

Fujimura, Joan H., and Christopher J. Holmes. 2019. “Staying the Course: On the Value of

Social Studies of Science in Resistance to the ‘Post-Truth’ Movement.” Sociological

Forum 34 (S1): 1251–63.

Hartley, Kris, and Darryl S. L. Jarvis. 2020. “Policymaking in a Low-Trust State: Legitimacy,

State Capacity, and Responses to COVID-19 in Hong Kong.” Policy and Society 39

(3): 403–23.

Heymann, David L., and Guénaël Rodier. 2004. “Global Surveillance, National Surveillance,

and SARS.” Emerging Infectious Diseases 10 (2): 173–75.

Huang, Yanzhong. 2004. The SARS Epidemic and Its Aftermath in China: A Political

Perspective. Learning from SARS. National Academies Press.

Jasanoff, Sheila. 2004. States of Knowledge: The Co-Production of Science and the Social

Order. Routledge.

Jennings, Ralph. 2020. “How Cultural Differences Help Asian Countries Beat COVID-19,

While US Struggles.” Voice of America. July 22, 2020.

Jiang, M. (2016). The coevolution of the Internet, (un)civil society, and authoritarianism in

China. The Internet, social media, and a changing China. University of Penn Press.

Knowles, Scott Gabriel. 2012. The Disaster Experts: Mastering Risk in Modern America.

University of Pennsylvania Press.

Lakoff, Andrew. 2015a. “Global Health Security and the Pathogenic Imaginary.” In

Dreamscapes of Modernity. edited by Sheila Jasanoff and Sang-Hyun Kim. Chicago:

University of Chicago Press.

Lakoff, Andrew. 2015b. “Real-Time Biopolitics: The Actuary and the Sentinel in Global

Public Health.” Economy and Society 44 (1): 40–59.

Lee, Jong-Wha, and Warwick J. McKibbin. 2004. Estimating the Global Economic Costs of

SARS. Learning from SARS. National Academies Press.

Lu, Yingdan, Jennifer Pan, and Yiqing Xu. 2021. Public sentiment on Chinese social media

during the emergence of COVID-19. JQD: DM. 1.

Martin, Timothy W., and Marcus Walker. 2020. “East vs. West: Coronavirus Fight Tests

Divergent Strategies.” Wall Street Journal, March 13, 2020.

Mason, Katherine. 2016. Infectious Change: Reinventing Chinese Public Health After an

Epidemic. Stanford University Press.

McDonnell, Terence E., Christopher A. Bail, and Iddo Tavory. 2017. “A Theory of

Resonance.” Sociological Theory 35 (1): 1–14.

Olick, Jeffrey K., and Joyce Robbins. 1998. “Social Memory Studies: From ‘Collective

Memory’ to the Historical Sociology of Mnemonic Practices.” Annual Review of

Sociology 24: 105–40.

Pierson, Paul. 2004. Politics in Time: History, Institutions, and Social Analysis. Princeton

University Press.

Rosenberg, Charles E. 1989. “What Is an Epidemic? AIDS in Historical Perspective.”

Daedalus. 118(2): 1-17.

Seawright, Jason. 2016. “The Case for Selecting Cases That Are Deviant or Extreme on the

Independent Variable.” Sociological Methods & Research 45 (3): 493–525.

Sewell, William H. 1990. “Three Temporalities: Toward a Sociology of the Event,” 37.

Sismondo, Sergio. 2017. “Post-Truth?” Social Studies of Science 47 (1): 3–6.

Swidler, Ann. 1986. “Culture in Action: Symbols and Strategies.” American Sociological

Review 51 (2): 273–86.

Tavory, Iddo, and Nina Eliasoph. 2013. “Coordinating Futures: Toward a Theory of

Anticipation.” American Journal of Sociology 118 (4): 908–42.

Wan, Kin-Man, Lawrence Ka-ki Ho, Natalie W. M. Wong, and Andy Chiu. 2020. “Fighting

COVID-19 in Hong Kong: The Effects of Community and Social Mobilization.” World

Development 134: 105055.

Wang, Yu, Nijuan Xiang, Daxin Ni, Qun Li, and Zijian Feng. 2017. “Performance of

Surveillance System of Pneumonia with Unknown Etiology in Two Hospitals at

Municipal in Anhui Province.” Disease Surveillance 32 (5): 428–32.

Whooley, Owen. 2013. Knowledge in the Time of Cholera: The Struggle over American

Medicine in the Nineteenth Century. Chicago: University of Chicago Press.

Yang, Zeyi. 2020. “Pandemic Coverage and Information Gaps.” Columbia Journalism Review.

April 27, 2020.

Zerubavel, Eviatar. 1997. Social Mindscapes: An Invitation to Cognitive Sociology.

Cambridge: Harvard University Press.