In San Francisco in the 1970s and 1980s, it was routine to see men from China spit in the streets, blow their noses in their fingers and then wipe their hands on anything nearby, and generally violate American hygienic norms. Outside the tourist zones, Chinatown's restaurants and grocery stores also suggested resistance to American hygiene.

The Chinese who came to America to escape communism were amazing people and model immigrants. They worked hard and were so family-focused and education-oriented that, usually within one generation, they made the leap from Chinatown squalor to lovely suburbs. However, unlike the Japanese, the Chinese did not bring with them a culture of cleanliness.

When it comes to epidemic diseases, these cultural norms matter — and political systems may matter even more.

One of the things noted here last week is that the coronavirus, unlike ordinary respiratory viruses, may also be transmitted through fecal matter (emphasis added):

That reference to hygiene in China gained new meaning from reading a viral post from Regie Hamilton, who was in China eighteen years ago to adopt his daughter. He vividly remembers the cultural comfort with fecal matter and other disease vectors:

When my wife and I got off the plane, 18 years ago, to adopt our first daughter, we were taken aback by the split pants. Split pants are (or at least were, back then) pants the children wear that are open in the crotch area. That allows them to urinate or defecate unobstructed, onto the street or wherever they may be. The theory is that eventually they will learn to "aim it at the toilet" or something to that effect. Either way, I distinctly remember my brand new Nike slip-ons (probably made not far from where I was standing) sloshing into a mix of urine and who knows what else, and continuing to do so for the next three weeks. [snip] Over the next several days and weeks, we would experience the amazing culture of China, in several different cities. But some things stood out to this germophobic American. I watched a man hock up something from his chest and spit it on the floor, right next to us, in a restaurant. No oysters for me, thanks. I've suddenly lost my appetite. We visited a Hutong (inner city — where the locals live) and saw raw chickens, skinned and bleeding, just laying on the floor, waiting to be thrown on a restaurant grill...for public consumption. No FDA or USDA or food inspectors or "codes" to comply with, here. But why? This is the last purely communist country on earth. You'd think there would be red tape everywhere. What was happening here?

Hamilton thinks there's a greater problem in China than filth, and that's socialism. After taking his new daughter to the hospital and seeing that it was as filthy inside as the streets were outside, he knew what was wrong. When there's only one entity selling health care and that entity is a police state, two things happen — people have no recourse when the system fails, and the system has no incentive to improve:

I was witnessing the kind of maximum, almost brutal efficiency a society must develop when the state is the master and the individual is merely a subject. Why would a Communist country not have an effective FDA? Because who are you going to complain to if you get tainted food? The government? They don't answer to you. The press? They are owned by the government. And again, they don't answer to you. So what if you don't like the conditions in the hospital? Where else are you going to go? This hospital is the last (and only) stop. You can't opt for another place and then just pay out of your own pocket. The government has capped financial upward mobility. There is now "income equality." And that means nobody has the means to buy their way into a different (or better) situation. And even if you could, one doesn't exist. The state provides it all. You're stuck.

Hamilton's post is magnificent and a necessary antidote to the leftists insisting that socialized medicine is the answer to epidemic disease. You should read the whole thing.