This story first appeared in China Report, MIT Technology Review’s newsletter about technology developments in China. Sign up to receive it in your inbox every Tuesday.
Almost exactly a year after the World Health Organization declared mpox (formerly known as monkeypox) a public health emergency, the hot spot for the outbreak has quietly moved from the US and Europe to Asia. China in particular is experiencing a concerning increase in mpox cases right now.
This morning, I published a story on the developing mpox situation there and the government’s response so far. While Beijing did recently issue a guidance on mpox prevention, the country hasn’t taken a very proactive approach to containing the outbreak—a stark contrast from its strict covid policies (which I wrote about extensively last year).
It’s particularly worrying that the government hasn’t talked at all about using mpox vaccines, though there are three options available globally and they have proved to be effective at containing the mpox spread in countries including the United States.
Beijing’s omission may be a result of “technology nationalism,” says Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. But delaying the approval of effective foreign vaccines could stymie prevention and result in more dangerous outcomes, Huang warns—the same thing that happened with covid.
You can read more about the difficulties in containing the mpox spread in China in the story today.But in this newsletter, I want to highlight a different challenge: because of the way Beijing has so far reported mpox data and the way the WHO publishes it, it’s quite difficult to understand the exact scale of mpox in the country.
When I started reporting this story, I found that the only available mpox case count China has published is a one-time report tallying cases from June 2 to June 30. No information on weekly developments or cases from before or after June has been made public, even though other Asian countries, including Japan, started to see cases rise back in March.
But when I looked up the WHO dashboard on the global mpox outbreak, with data starting in January 2022, I was surprised to find a consistent stream of new cases being reported by China several times a week, as recently as July 20.
For some time I thought this meant Chinese health authorities or researchers had been quietly reporting more timely data to the WHO while keeping the information inaccessible to the public. After all, something similar has happened before with covid data.
Honestly, I found this data surprising and alarming. News about mpox in China has been mostly under the radar, but as the WHO overview explains: “In the most recent week of full reporting, 7 countries reported an increase in the weekly number of cases, with the highest increase reported in China.” The WHO data shows that from May to July, China reported 315 mpox cases, the most around the world in this time frame.
Sounds quite bad, right?
It turns out the reality is a tad more complicated. On the WHO website, the recent mpox data listed under China is the sum of cases reported in China, Taiwan, and Hong Kong.
The lack of data separation is significant here for a few reasons. First, while case counts have indeed risen in China, we don’t know by how much and over what time frame. China reported 106 cases in June alone, and it’s safe to assume there were additional cases in May and July. But there’s no information there to help us understand the exact urgency and severity of the outbreak, which can lead to panic and uninformed interventions. What’s more, as its handling of covid shows, the Chinese government may be holding onto data to serve its own interests.
Beyond that, this combined data reporting obscures the fact that Taiwan and China, with their different governing bodies, have responded to public health emergencies in very different ways.
While China has not signaled any interest in using mpox vaccines, Taiwan, which has its own CDC, has already administered over 72,000 shots so far. While China has only issued a one-month report of case counts, Taiwan has a public database showing how many new cases are reported each week, making it easy to see that the outbreak is on the decline there, six months after local transmission started.
So aggregating very different sources of data creates a confusing landscape and makes it hard to follow the impact of public health measures.
This means that when the WHO data shows a 550% increase in weekly new cases in China between July 10 and July 17, the jump means little. It doesn’t reveal the direction of the mpox outbreak; it only emphasizes the broken, irregular pattern of case reporting from China.
This is not to say the outbreak in China is insignificant, but that the data on the WHO website can easily mislead observers.
It’s important to realize that despite how authoritative they may sound, international organizations like the WHO don’t have a magic source of data that overcomes the limited public health information coming out of China. It can only rely on individual countries to voluntarily report such data. (The WHO didn’t immediately respond to questions about its data aggregation practices; today is a public holiday in Switzerland, where it’s headquartered.)
Unfortunately, as the status of Taiwan remains one of the most sensitive security topics to Beijing, even the act of singling out the island’s public health data can be seen as a political move. That is larger than any technical obstacle. At a crucial time like this, transparent and timely case counting is one of the most important public health tools against infectious diseases. It’s too bad that politics is getting in the way of that.
Do you think WHO should disaggregate the mpox data of China and Taiwan? What are your reasons? Tell me at zeyi@technologyreview.com.
Catch up with China
1. Chinese feminists are rushing out to support the Barbie movie. (But you can’t do a “Barbenheimer” double feature yet, since Oppenheimer isn’t arriving in China until August 30.) (Financial Times $)
2. The US government believes Chinese hackers have inserted malware into the communications, logistics, and supply networks of US military bases. (New York Times $)
3. A former party official in the city of Hangzhou, who oversaw the rise of tech giant Alibaba, was imprisoned for life for taking $25 million in bribes. (Bloomberg $)
4. Volkswagen bought a 5% stake in the Chinese electric vehicle company Xpeng, and the companies will jointly develop two EV models under the Volkswagen brand. (Wall Street Journal $)
5. TikTok’s newly launched ad library in Europe shows that Chinese major state media have run over 1,000 ads on the platform, even though TikTok’s policy forbids political ads. (Forbes)
6. Shein spent $600,000 on lobbying activities between April 1 and June 30, nearly three times its lobbying spending in the first quarter. (Business of Fashion)
7. China will restrict the export of long-range civilian drones, citing concerns that they might be converted to military use. (Associated Press)
8. A Taiwanese businessman accused of espionage and stealing state secrets was freed after two years in a Chinese jail. (BBC)
Lost in translation
A new AI photo generator app called 妙鸭相机 (Miaoya Camera), developed with support from a Alibaba-owned company, is all the rage in China right now. Users can upload 21 photos with their faces to create personalized portraits that look as if they were created by a professional. It’s priced at just 9.9 RMB ($1.38), a tiny fraction of what chain photography studios often charge. (These studios have become a popular business in recent years.)
Experts told Chinese publication Southern Metropolis Daily that the technology Miaoya Camera uses—mostly the open-source model Stable Diffusion and a technique called “low-rank adaptation of large language models” to improve the result—is nothing groundbreaking but just well packaged for the user experience. Expectedly, a controversy then arose about the broad data use permissions in the app’s user agreement; the app apologized and promised it will use personal data only to generate profile photos.
These Barbies and Kens are from Dongbei, the northeastern region of China, where food portions are gigantic and people are often stereotyped as being straightforward and tough. (Sort of like the Texas of China, you know.) But really, these are created by an AI artist, Kim Wang, through Midjourney. I talked to Wang in a story earlier this year about using Midjourney to reimagine Chinese history.
Hazmat suits, PCR tests, quarantines, and contact tracing—it was hard not to feel déjà vu last week when China’s Center for Disease Control and Prevention published new guidance on how to contain a disease outbreak.
But what was happening was not another covid wave. Rather, the Chinese government was addressing a potentially significant new public health concern: mpox. The World Health Organization reports China is currently experiencing the world’s fastest increase in cases of mpox (formerly known as monkeypox), and the country needs to act fast to contain the spread.
While the Americas and Europe have mostly contained the mpox outbreak that started in mid-2022, Asia has emerged as the disease’s new hot spot. Japan, South Korea, and Thailand, which all saw sporadic imported cases last year, have reported weekly new case numbers in the double digits in 2023, meaning the virus has been spreading in the domestic population. But according to the latest data reported to the WHO, China has surpassed all other countries in the world, with 315 confirmed cases in just the past three months—though irregular case reporting from Beijing means it’s impossible to know the true scale of the disease at this point.
Mpox is less contagious than covid, but since 2022, more than 88,000 people have contracted the disease, which can be painful and even debilitating for some. More than 150 people have died. Some countries have been more successful than others at containing domestic mpox outbreaks—and much of their success is arguably a result of proactive measures like vaccination campaigns.
But the Chinese government has barely started to take action.
“Compared with the response to covid-19 … the [Chinese] response is certainly dramatically different,” says Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. “Even though [mpox] is less likely to develop into a large outbreak in the country, the Pollyanna attitude may encourage the spread of the disease among the at-risk population—unless they take a more active campaign against the disease.”
How it’s spreading now
In May, the WHO declared that mpox was no longer a public health emergency of international concern (PHEIC) because cases had gone down significantly in countries that had seen large outbreaks last year, mostly in the Americas and Europe. (Mpox has been endemic in West and Central Africa for decades and remains so.)
“Overall, compared to where we were last year, we’re definitely in a different place,” says Krutika Kuppalli, an infectious-disease physician and chair of the Infectious Disease Society of America’s Global Health Committee. “We have much fewer cases, but we are seeing sporadic outbreaks in different parts of the world.”
Indeed, by the time the WHO rescinded the PHEIC declaration, many Asian countries were already starting to see an uptick. Japan was the first Asian country to report a significant increase in mpox cases, in March. In May, a report by researchers in the country warned that the disease could surge across Asia, owing to the connectedness between Japan and other Asian countries and the low mpox vaccination rate in the region. If the outbreak grows to the level that it did in the West, the researchers noted, over 10,000 cases might be expected in Japan alone before mpox is successfully contained.
It’s less clear what exactly is happening in China. According to data collected by the WHO, China reported 315 new mpox cases from May to July. A case count this high suggests that not all cases were travel related.
But—in another situation reminiscent of its covid response—China isn’t as forthcoming as other countries with its disease data; it doesn’t publish weekly reports of new cases. Rather, it has released a one-time report of the number of mpox cases recorded in June: 106. The Chinese government didn’t release data from May, and hasn’t released any data about July cases yet.
The WHO, though, lumps together the case counts from Taiwan, which has its own government and CDC, and Hong Kong under the name of China. And there’s no way for the public to separate the data. So the 315 number includes the 106 cases Beijing says it identified in July, plus the number of infections in Taiwan and Hong Kong over May, June, and July.
This all further obscures the true toll of mpox in China—even though it’s critical during an infectious-disease outbreak to be on top of things as soon as possible.
The Chinese name for mpox—猴痘, or houdou—has also been thrown around casually as a slur against gay men.
“We also need to understand more about the people that have been infected,” Kuppalli says, “such as … the demographics, the clinical presentation, their immune status, and about how they’ve been presenting to care. I think that type of information is important.”
A muddled response that makes LGBTQ communities a target
The lack of clarity on how the disease has spread has caused some Chinese people to panic. The news that mpox cases have started to appear in the country has been circulating for weeks. But not until July 26 did China’s CDC and health ministry co-publish a new guidance on how to prevent its spread, and even that left unanswered questions.
The directive asked that all confirmed mpox patients transfer to a medical facility for quarantine unless they have only mild symptoms. It said contact tracing going back three weeks would be conducted for every patient, and their close contacts would be asked to self-quarantine for three weeks. It also recommended that local authorities monitor the mpox virus level in wastewater around certain areas.
What makes monitoring the outbreak more difficult in China is that, as in the West, the current mpox spread has been seen mostly among communities of men who have sex with men (MSM). And similar to what happened in the US and Europe, that association is consistently misinterpreted in China to suggest that mpox is only an STD spread by gay men through sexual activities—a particularly dangerous connection, as the LGBTQ community is increasingly targeted in the country.
Many Chinese social media users who have spotted men withskin lesions in public have been posting their photos to ask whether it’s an mpox symptom. And the Chinese name for mpox—猴痘, or houdou—has also been thrown around casually as a slur against gay men.
To efficiently stop the spread of mpox, public health officials need to strike a delicate balance between destigmatizing the disease by dispelling the idea that it affects only gay men and prioritizing the MSM communities that are most vulnerable to it.
“Working with the people that are affected, helping to have non-stigmatizing language and communication, has been hugely effective in helping to curb the outbreak” in the West, Kuppalli says.
So far, some local LGBTQ communities in China feel they’re on their own.
M, who works for a queer rights organization in Guangzhou and asked to be identified only by his first initial given the sensitivity of his work, points out that the CDC recommended wastewater monitoring specifically near venues that MSM communities frequent, including bars, clubs, and saunas. He says this has become controversial within the Chinese LGBTQ community, and that some organizers feel this puts a target on their backs.
“It will take a long time. I have some friends who have already traveled to Hong Kong or Macau to get vaccinated for mpox.”
Another LGBTQ organizer, Suihou, who works in the central province of Hubei and asked to be identified by a pseudonym, tells MIT Technology Review that even though contact tracing information is supposed to be strictly confidential, he has seen one example in which an mpox patient’s private information, including phone number, national ID, address, and HIV status, was leaked and passed around on social media.
Organizers like M and Suihou are doing their own work to mobilize a disease response. To spread information about mpox prevention, M has recently sent text messages to 700 people and hosted in-person lectures that reached over 900 people.
And Suihou has worked with one mpox patient closely, helping him get testing and treatment. Not all the medical workers they’ve encountered have been trained on how to handle the sensitivity of these cases, he says; during the contact tracing process, the doctor told the patient that this disease is a problem for “your kind of people.”
Suihou warns that some people may avoid seeking medical help altogether, particularly given the lack of state support for mandatory quarantine and contact tracing.
“From the individual cases that I have heard of, everyone who has a confirmed case is being asked to go to a quarantine facility,” Suihou says. But, he explains, since the government has not provided a budget to help cover the quarantine, as it did with covid, patients have no choice but to pay for the hospital stay and all medical tests out of their own pockets. Many marginalized individuals, who are also more vulnerable in an infectious-disease outbreak, may not be able to afford that.
“With the slowdown of the [Chinese] economy, local governments don’t have the physical capacity or even the willingness to invest more in public health,” Huang explains. Even the WHO doesn’t have funding specifically earmarked for mpox prevention; it has been using its emergency fund to cover mpox-related work.
A lot of the financial burden will again fall on local organizers. M tells me that his organization is using funds intended for HIV prevention to conduct mpox outreach work.
All of this could further disincentivize people who get infected from seeking medical tests and treatment. This in turn would make the community spread of mpox even harder to track—and could undermine prevention efforts taken so far.
A lack of available vaccines
Much as with covid, vaccination is one of the best ways to get mpox under control. Worldwide, three vaccines are currently being used for mpox prevention: ACAM2000, MVA-BN (also known as JYNNEOS in the US), and Lc16m8. All these vaccines were originally designed for protection against smallpox but have been found effective against mpox.
The US has administered more than 1.2 million JYNNEOS and ACAM2000 shots. And in Asia, South Korea imported 10,000 JYNNEOS shots last year and is planning to procure another 20,000 this year, while Taiwan, despite its small size, has procured and administered over 72,000 JYNNEOS shots so far. Japan, meanwhile, has relied on a Japanese company to produce its own Lc16m8, while also donating doses of the vaccine to countries including Colombia.
But none of these vaccines have been approved for use in China. The situation recalls how China refused to import any mRNA covid vaccines, instead relying on a few homegrown vaccines that were shown to be less effective. In this case, though, the country doesn’t currently produce any of its own smallpox vaccines; production was terminated after smallpox was eradicated globally in 1980.
Bavarian Nordic, the Danish company that produces the JYNNEOS vaccine, tells MIT Technology Review that it can’t disclose client information unless requested by the government and can’t confirm whether China has procured any JYNNEOS shots. But it says the company is not in the process of applying to register the vaccine in China.
The WHO also has a sharing mechanism in place that allows member states to receive vaccines if needed. But it’s unclear whether China has applied for mpox vaccines. The organization did not immediately respond to an inquiry about whether there are plans to send vaccines to China.
The new Chinese CDC guidance on mpox made no mention of any vaccine as part of its outbreak response. “It’s quite unlikely that China will focus on procuring vaccines at this moment, since there’s no precedent and [no] emergency approval of the vaccines. Rather, there seems to be a focus on surveillance, monitoring, quarantine, contact tracing, etc.,” says Zoe Leung, a senior associate at Bridge Consulting, a Beijing-based communication consultancy specializing in public health.
It may not be this way forever: Sinopharm, a Chinese state-owned pharmaceutical company, announced last November that it had developed the world’s first mRNA vaccine against mpox, and it has been found effective in preclinical studies. On July 13, Sinopharm officially applied for clinical trial approval for a “replication-defective mpox vaccine,” though it’s unclear whether these are the same products. Sinopharm did not immediately reply to questions about its mpox vaccine development.
“There is domestic research [on a mpox vaccine], but we don’t know when it can be commercially available. It will take a long time,” says M, the organizer in Guangzhou. “I have some friends who have already traveled to Hong Kong or Macau to get vaccinated for mpox.”
But for Chinese people to get vaccinations outside mainland China, there is often a high cost, a long wait time, and layers of bureaucracy to wade through. It’s again similar to trends seen earlier in the pandemic, when Chinese people with means traveled to Hong Kong to get mRNA covid vaccines.
“It doesn’t necessarily mean [Beijing is] not interested in vaccines,” says Huang, “but there’s this technology nationalism that discouraged them from rapid approval of the use of foreign vaccines.” And that, he warns, “certainly contributed to the rapid increase in covid-related mortalities.”
Days after learning that her husband, Ted, had only months to live, Claire Matte found herself telling strangers about it in VR.
The 62-year-old retiree had bought a virtual-reality headset in 2021 as a social getaway. Ted had late-stage cancer, and the intense responsibility of caring for him had shrunk her daily reality. With the Oculus, she’d travel the world in VR and sing karaoke.
But last January, after 32 failed rounds of radiation, a doctor had told Matte and her husband that it was time to give up on treating his cancer.
“[Ted] did not want to know how long he had,” she tells me. “He left the room.” But Matte felt that, as his caretaker, she had to know. When Ted was out of earshot, the doctors told her he had four to six months to live.
On the car ride home, Ted asked if he had at least six months left. Matte decided “yes” was an honest enough answer.
Ted took his prognosis in stride—he stayed excited for the next football season, and Matte caught him laughing in front of the TV hours after the news. But he grew too sick to leave the house or, given his fragile immune system, to see guests. Their isolation deepened.
Matte still had the virtual world, though she says, “After the death sentence, I didn’t exactly feel like singing.” Later that month, as she checked out a calendar of live meetups to attend in VR, one event caught her attention: “What’s this Death Q&A?”
A virtual destination where conversation can veer from the abstract to the incredibly intimate, Death Q&A is a weekly hour-long session built around grappling with mortality, where attendees often open up about experiences and feelings they’ve shared with no one else. Bright, cartoon-like avatars represent the dozen or so people who attend each meetup, freed by VR’s combination of anonymity and togetherness to engage strangers with an earnestness we typically reserve for rare moments, if we reveal it at all.
During my four months sitting in on Death Q&A and similar sessions, I’ve heard people process cancer diagnoses, question their marriages, share treasured memories of parents and friends who’d passed hours before, turn over childhood traumas, and question openly how we can stare down our own mortality.
Despite the perception that they’re just for gaming, more people like Matte are putting on VR headsets to talk through deep pain in their day-to-day lives. The people attending VR meetups like Death Q&A are test-driving a new type of 360° digital community: one much more visceral and consuming than Zoom or the online forums that came before, and untethered to the complex social network that grounds and creates tension in traditional, face-to-face experiences.
“These relationships that we make in VR can become very intimate and deep and vulnerable,” says Tom Nickel, the 73-year-old former hospice volunteer who runs the virtual meetups with co-host Ryan Astheimer. “But they’re not complicated. Our lives don’t depend on each other.”
These people don’t share a bathroom. They don’t need to get out of bed or look presentable. They just have to listen. Many people call the meetups a lifeline—one that was particularly needed during the pandemic but seems poised to persist long after, as money continues to be pumped into building out the metaverse and loneliness crushes more people than ever.
Building an intimate VR community
Entering Death Q&A plops you in front of an inviting reproduction of a Tibetan Buddhist temple, surrounded by images from a different real-life graveyard each week. People arrange their virtual selves to face Nickel, who stands at the front by an altar. He begins most sessions by asking in a warm, neighborly voice if anyone has come with something specific to share.
About 20% log on from computers, which deliver only a 2D experience; the rest attend using VR headsets, so I put one on too. Wearing it, you hear other attendees so close up—the tremble in their voices, and a bouquet of accents. It’s as if they’re in your ear, whispering. Laughter and tears seem equally common.
The atmosphere in the sessions feels nostalgic and confessional—spectating has often felt like crashing a church service or family reunion. The crowd brings a palpable curiosity about the lives of the other attendees. Before Nickel kicks off each session, regulars often clump together to catch up; after the hour, most attendees strike up unmoderated conversations and choose to linger.
Claire and Ted Matte
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Matte attended her first Death Q&A right after she learned how soon her husband would die. Though Ted didn’t want to know, “those people, I could tell how long he had left,” she says.
After Matte shared, someone raised their hand to empathize, describing how they’d grieved and recovered from losing their spouse. This is one of the most striking things about Death Q&A—sharing almost always inspires someone else to talk about an experience so similar that participants feel they’ve found a person who actually understands what they’re going through.
“I knew by the end of it I was going to attend these every Tuesday at one o’clock Eastern,” Matte says.
At Death Q&A, Matte met Paul Waiyaki, a 38-year-old man living in Kenya. Matte, who lives in Georgia, now calls him one of her closest friends. “It’s just like back when you were in kindergarten, and you would look at someone and go—‘Hi, I want to be friends,’”she says. “As an adult, you don’t make friends like that. But on Oculus, with an avatar, you sure can.”
Waiyaki says he didn’t allow himself to process his sister’s death until he did it through VR. “Men, in my society, can’t be seen breaking down,” he explains. “At Death Q&A, I was able to put the baggage down. I was able to mourn and cry the tears I hadn’t cried before. It hurt to, but I could feel a wound heal as I did.”
Saying goodbye during a pandemic
Death Q&A and a similar evening session called Saying Goodbye, which is focused on loss, are just two of the 40 or so live events offered each week by EvolVR, a virtualspiritual community that was founded in 2017 by Tom Nickel’s son, Jeremy.
Before starting EvolVR, Jeremy Nickel led an interfaith church congregation in the Bay Area that was “very liberal in theology,” he says. He was looking for new ways to minister, untethered to the conventions of mainstream religion, when he first tried on a VR headset in 2015.
“The lightbulb went off in my head—people feel like they’re really together in VR,” Jeremy says. That feeling of true presence, as if avatars were really sharing a room together, convinced him that a spiritual community could form among people wearing headsets. He left the physical pulpit to host live group meditations in VR.
Then the pandemic hit. Both Saying Goodbye and Death Q&A began in early 2020—“our response to understanding that people would be losing a lot,” Tom Nickel says. They knew “that maybe people would need places to talk about it,” especially as covid precautions took away hospital-bed goodbyes and shrank people’s social circles.
Nickel, a cancer survivor himself, had spent years helping the dying depart comfortably as a hospice caregiver. That helped him gently moderate crowded Saying Goodbye and Death Q&A sessions as people joined to mourn friends and family, lament canceled graduations and closed beaches, and air anxiety about the fragility of elderly family members.
Covid-19 also triggered a wave of what psychologists call mortality salience—the realization that death isn’t only possible, but inevitable.
Elena Lister, a psychiatrist at Columbia University who specializes in grief, says a healthy level of denial about death is necessary. But now, Lister says, her colleagues are talking about a pandemic of loss that’s being felt across society—the product of mass death compounded by stunted mourning.
“What those people are doing is having an experience where they’re putting what’s deeply, deeply painful inside of them into words.”
In particular, doctors like Lister worry about complicated grief, a psychiatric disorder diagnosed when, a year after a loss, the pain of acute grief hasn’t begun muting. About 10% of the bereaved have it; they remain severely socially withdrawn and despairing, incapable of resuming the activities of their life.
The pandemic created particularly fertile ground for complicated grief. Funerals are meant to kick-start the process of integrating loss into our new reality, but for two years, “we couldn’t be together to hug and cry and sob,” she says. Lister thinks experiencing the pandemic has actually left peoplemore avoidant of discussing death.
To explain the promise of processing grief in VR, Lister paraphrases wisdom from Mr. Rogers: “What’s mentionable is manageable.” When avatars file into Death Q&A, “what those people are doing is having an experience where they’re putting what’s deeply, deeply painful inside of them into words,” Lister says, turning raw torment into something workable.
Social isolation makes it more likely that loss will harden into complicated grief. But mourning invites estrangement. Everyday conversation can feel unbearably trite when your loss feels so much more piercing, but “after a while people don’t want to hear it because they can’t fix it for you,” Nickel says. Death Q&A hands a mic to that pain and supplies an eager audience; Lister says having that community is great for promoting a healthy progression through grief.
A VR support group might suit you better than a traditional one because “there’s protection,” she says. “You can control what’s seen about you.” Sharing through an avatar, to people you never have to see again, creates a digital veil that liberates people to be shockingly honest and vulnerable.
Indeed, this echoes how Matte describes her VR experiences. “I would come and say some pretty bad things in a matter-of-fact voice, and often [Nickel] would say—‘Whoa, you know, let’s stay with this a while,’” Matte says, noting howTed worried about being a burden. “Some days I really don’t know how I went without walking around the house bawling all the time … so I told myself: Get your shit together.” Airing her devastation in VR helped her focus on making his death as comfortable as possible.
By 2021, Jeremy Nickel felt his nonprofit organization had reached an inflection point. EvolVR says 40,000 people had participated in its events since 2017. At that point, “we can either stay this sweet little thing that’s serving a couple hundred people,” he figured—or “we could make a play and try to share this with a whole lot more.”
He opted to create spaces where people can practice this new way to mourn and process in huge numbers.
In February 2022, he sold EvolVR to TRIPP, a Los Angeles–based company, for an undisclosed amount. TRIPP, which raised over $11 million in funding from backers including Amazon the previous year, has offered VR-guided meditations since 2017; the sessions have people do things like visualize their breath as stardust, coming in and out at the ideal pace to meditate.
But TRIPP’s VR meditations were solo experiences. By acquiring EvolVR, the company got a chance to tap into the unstructured, relationship-driven world of social VR, which provides a gathering space where anyone can attend events or meet people at virtual destinations open 24/7.
A “paradigm shift” for the sick and elderly
Saying Goodbye is Death Q&A’s nighttime counterpart, which Tom Nickel also runs on Tuesdays. Avatars gather around a firepit that’s lit at the end of each session.
Tom Nickel, next to his avatar
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Most attendees dress casually, while a few choose unnatural skin tones like bright blue. I dressed my own avatar in drab business casual, hoping to be inconspicuous. But after taking raised hands, Nickel calls on quiet attendees, asking if there’s anything on their minds that they’d like to share. During two Saying Goodbye sessions, I surprised myself by answering yes—once to talk about a painful breakup and the next time to share my mom’s cancer diagnosis. I’d spoken to friends about both, but venting in VR gave me permission to air the anxieties that their consolations couldn’t shake, without worrying about being melodramatic.
The age of participants varies, but most are over 30, and many are over 60. This initially surprised me, though in hindsight, the particular appeal of VR for older people is obvious.
A regular at Saying Goodbye, a user with a British accent and the screen name Esoteric Student, tells me he bought an Oculus on a whim in 2020. That year he lived with his nan, who was seriously ill. He watched her world shrink.
“Imagine being an 80-year-old lady and seeing your circle get smaller,” he says. “So you start off with the boundaries of the house. And it just keeps getting smaller, until you’re in one spot. And that’s it.”
He showed her the Oculus and asked, “Want to go on a spacewalk?”
They tried out a popular experience from NASA that lets you view Earth from the International Space Station. It made him sick, but his grandmother loved it. She’d never left the country.
Before she died, she saw more of the world and parts of Mars through real, crystal-clear, immersive images rendered in VR.
I’d spoken to friends, but venting in VR gave me permission to air the anxieties that their consolations couldn’t shake, without worrying about being melodramatic.
“Coming from the Great Depression to running to bomb shelters in Birmingham to eventually spending her last days being able to ascend, in a way?” he explains, crying a little bit. “It’s a paradigm shift.”
Some familiar faces at Saying Goodbye and Death Q&A are terminally ill or disabled. VR can offer a path to friendship and fresh experiences that cuts through people’s physical limits. It can also help the elderly avoid the loneliness they might feel as they watch friends die and children move away, and as retirement removes them from the working world.
Matte experiences mobility issues herself. “So I can go in VR and run, jump off a building—you know, everything under the sun,” she says. “Be young again, really.”
How far virtual support can go
Despite all its promise, at least one thing about processing emotions in VR makes Lister nervous: How do you know if people are so distressed they are at risk of harming themselves?
“It allows for more hiding,” she notes. When people interact as avatars, the nonverbal communication that psychiatrists are trained to notice, like hand gestures and fidgeting feet, is simply lost.
And the name Death Q&A can particularly attract people in crisis. Toward the end of one Death Q&A session I attended in September, an avatar in a lime green snapback, who sounded young, asked if he could speak. He’d tried to kill himself a few weeks before and said he’d found immense peace in the decision. But having survived, he told us, his behavior had changed—he was flirting with girls nonstop and found everything funny. He came off as strikingly light and unbothered. His question was: I’m still here. Now what?
Nickel sprang into action—offering, with a gentle urgency, to connect him to other survivors of suicide and asking if the young man could talk one on one after the session.
“I have to do my best to understand: Are you in a safe place right now?” Nickel says he asks himself when an attendee shares something that worries him. In addition to working in hospice, Nickel also previously worked as the director of continuing education at the California School for Professional Psychology, where he took and helped develop workshops on suicide awareness and response. But he says these trainings all need updating and rethinking for VR.
“I think that the best I can do is to offer a daily, hearing, non-judging, non-trying-to-save-anybody contact,” he says. When people in the meetup seem “shaky,” Nickel DMs them and shares his personal email. The boy in the snapback never replied. But some people do. “And in a couple of cases, I called every day.”
Lister agrees that anyone expressing suicidal ideation needs repeated support from someone highly trained. She says that if you’re going to do grief work virtually, there needs to be “a full understanding of how to reach this person, and what the follow-up is”—though, even in person, you can’t make anyone return to get help.
The more muscular tools of suicide prevention, like constant monitoring and physical restraints, are also not available in VR. “If somebody came to me in person and said they were suicidal or had tried to end their life last week, I would have great pause about having them leave my office until I felt like I could secure their safety,” Lister says.
“All I had to do was put on a headset”
In the months after Ted’s prognosis, Matte updated her new friends and fellow avatars as Ted’s voice gave out and his legs shrank from sturdy to emaciated.
Then, two nights before Ted died, he suddenly awoke, full of energy, and asked his wife if they could order Chinese food.
“At Death Q&A, I was able to put the baggage down. I was able to mourn and cry the tears I hadn’t cried before. It hurt to, but I could feel a wound heal as I did.”
He’d slept through the day and hadn’t eaten or taken his medicine, which terrified Matte. That night they enjoyed pork fried rice together on the couch; Ted ate more than he had in weeks. He put the Cubs game on in the background—he was a loyal fan, despite being from New York. “He loved an underdog,” Matte says.
It was his last solid meal. Ted Matte died June 11, 2022, at age 77.
Matte decided to attend Death Q&A and Saying Goodbye two days later. “I sort of surprised myself, being able to go,” she says. “But all I had to do was put on a headset.”
Unlike most sessions, which move from person to person, the meetings were mostly spent on Matte. Attendance at Saying Goodbye that night doubled; people said they’d come to support Matte. Through months of meetups, they’d come to feel like they knew Ted. She told them about the process of his death and their conversations in hospice. “I said that I would be okay. And I knew he loved me. And I loved him dearly,” Matte says. “And so you give the person permission to die, really.”
Attendees offered condolences and asked questions. Matte says people are interested “to compare and learn” about how peers experience a similar loss differently.
On the EvolVR Discord a month after Ted’s death, Matte shared that she’d gotten four straight nights of good sleep: “I’m onto something.” Three months out, I joined Matte in a Death Q&A session where she shared the frustration of handling an earache without Ted: “I just want someone to commiserate with!” That prompted a first-time attendee to speak, through sobs, about her husband’s death a year and a half earlier. Matte invited her to Saying Goodbye that night and stayed after to comfort her.
It’s now been six months since Ted passed. Matte feels she’s reached a turning point; she says the edges of her grief have softened. But it saddens her to move further from that anniversary. She still spends a few hours in virtual reality each day. Some days she’ll do a meditation session, or play a game with friends. But her Tuesdays remain bookended by grief meetups.
Matte acknowledges Death Q&A isn’t for everyone. She says close friends have questioned whether the meetups are cultish. But sharing her grief in VR and offering what she’s learned has “felt like a warm blanket, to be honest.”
“I don’t know what my journey would have been like without it,” she says. “But I have to envision it as much worse.”
Hana Kiros is a former Emerging Journalism Fellow at MIT Technology Review. As a freelancer, she covers science, human rights, and technology.
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Lots going on this week. First, MIT Technology Review announced yesterday our picks for this year’s 10 Breakthrough Technologies. If you’ve been watching China, several items on the list should ring a bell, like the inevitable adoption of electric vehicles and the growing chip design structure known as RISC-V. These are areas where China sees an opportunity to challenge Western dominance. To understand why we think these technologies represent the future, I recommend you read the full list here.
You should also know that on Sunday, China officially scrubbed mandatory quarantine for inbound travelers, almost three years after the policy began. This would have been much bigger news at any other time, but right now the country is consumed by an unprecedented surge of domestic covid infections. An official in Henan, China’s third-most-populous province, recently estimated that nearly 90% of its residents have now been infected with covid. This means the health-care system is stretched thin, covid treatments are in high demand, and many people are worried about themselves and their loved ones, especially seniors and people with preexisting conditions.
It’s against this backdrop that scammers are finding new opportunities; unfortunately, they have started taking advantage of this wave of anxiety and fear in China by claiming on social media to sell covid treatments—particularly Paxlovid, the Pfizer-developed medication that has been the most effective in preventing severe covid symptoms.
Although Paxlovid has been approved for emergency use in China since February 2022, the actual demand for it had long been low since local spread was kept to a minimum by harsh zero-covid policies. But when the country suddenly reversed course and faced millions of people getting sick, the inventory of Paxlovid quickly ran out across China. Patients could only get the drug either through connections in elite circles or by competing with numerous other people waiting for the few online pharmacies to release their daily supply. It’s no surprise, then, that others went online—either to Chinese social platforms like Weibo and Xiaohongshu or to international ones like Twitter—seeking help from more resourceful people.
And that’s ground that’s ripe for scams.
Last week, I received a mysterious Twitter follower named “Boon Jin”—an account that uses an Asian-looking female doctor as the avatar and says in the bio, in clearly machine-translated Chinese, that she sells Paxlovid to China.
After I got in touch with “Jin” on WeChat, she tried to sell me Paxlovid for the price of 2,500 rmb ($370) per box of five tablets. After initially promising she could receive payment via the Chinese fintech app Alipay or bank transfer, she later insisted I pay either through the cryptocurrency USDT (the preferred method) or to a Paypal user in New Jersey with a completely different name and photo.
While this specific Twitter account disappeared a week later—it’s unclear whether it was deactivated voluntarily or by the platform—there are several similar accounts still running: “Jackie Wong,” “Li Haitao,” and “Yung Lin Xiang,” who also use photos of Asian-looking doctors as their avatars and market Paxlovid in broken, translated Chinese. In the Twitter comments on some of these accounts, at least two people said they paid hundreds of dollars without receiving anything.
This tactic—seemingly from scammers without Chinese backgrounds targeting Chinese immigrants abroad who may be looking for ways to send Paxlovid home—is pretty primitive. But it reminded me that when people are desperate to get treatment, they can miss or ignore even pretty obvious red flags.
Similar scams are, perhaps unsurprisingly, incredibly prevalent within China right now, and in the days since my messages with Jin, I’ve talked with several Chinese people who have been caught up in scams after they searched on social media for Paxlovid.
Liao, a Chinese woman in Shenzhen who asked that we only use her last name, was desperate when her father, a 54-year-old with preexisting conditions, was admitted to the hospital for covid on December 28 and almost lost consciousness the next day. When the doctor suggested Paxlovid but told her the hospital didn’t have any left, she went on the popular social media platform Xiaohongshu to post her call for help.
Soon people started messaging her to say they could sell her Paxlovid. One account claimed it had the Pfizer version (as opposed to the generic version produced in other countries) and could ship the medicine the same day. She paid the asking price of 3,600 yuan (about $530) without hesitation.
Yet the promised medicine never came, and the account she paid later deactivated. She reported it to the police but was told the chance of getting her money back is low. Luckily, Liao’s father has stabilized and no longer needs the medicine.
Liao is not the only victim. Another person who lives in Hubei tells me she met a scammer on Weibo and has since found out that he deceived at least 30 people out of nearly $30,000. The victims have formed a group chat to coordinate what they can do, and the scammer’s account remains active on Weibo even though it’s been reported repeatedly. It’s still posting photos of Paxlovid, looking for new targets.
“There aren’t many Paxlovid left today. DM me if you need it. #fight against the pandemic# #paxlovid#”
Even those who are lucky enough to find sellers who are not scammers still need to deal with other forms of deception—like counterfeit drugs and theft (since the package is labeled with the name of the medication). And some people have turned to generic alternatives to Paxlovid, like Primovir or Paxista, that are made by Indian pharmaceutical companies and are questionable in terms of efficacy; some labs in China have examined samples of these generic drugs and found no effective ingredients.
It’s the immense challenges in accessing Paxlovid in the first place that have made all this fraudulent activity possible. A lot of Chinese people are scared and anxious, and some have probably put too much stock in the power of Paxlovid. Most of them are not equipped with the knowledge of who should take Paxlovid or how to take it without risks, but they are just trying to find anything that could help a little bit.
Of course, this isn’t the first time scammers have taken advantage of desperate individuals; online scammers are always ready, in China and elsewhere, to profit from fears and emergencies. But questions remain about whether social media platforms like Twitter and Weibo are doing enough to curtail such activities and regain users’ trust.
The real solution would be to ensure steady and affordable access to covid treatment in China, but that may take more time. Pfizer failed to reach a deal with the Chinese health-care authorities this week to include the drug in public health insurance coverage. Access to Paxlovid has reportedly increased in hospitals in Beijing and Shanghai, yet it remains hard to get in most other places. Until the supply shortage is addressed, the scammers will stay, and more people will get hurt during their darkest moments.
Have you heard of any other types of scams taking advantage of China’s current covid crisis? I’d love to hear from you. Write to me at zeyi@technologyreview.com.
Catch up with China
1. In more news about Pfizer, the company denied earlier reports that it is in talks with the Chinese government to license a generic version of Paxlovid to be manufactured in China. (Reuters $)
2. Here’s a rare inside look into how President Xi Jinping changed his mind about China’s zero-covid policy. (Wall Street Journal $)
3. Chinese tech mogul Jack Ma will reduce his control of Ant Group—Alibaba’s spinoff fintech arm—from over 50% to just 6%. Ma has been retreating from his role since his criticism of financial regulators in 2020 tanked Ant Group’s IPO. (BBC News)
4. US computer maker Dell told suppliers that it aims to stop using chips made in China by 2024. HP is gauging similar possibilities. (Nikkei Asia $)
5. For some YouTubers, predicting China’s economic collapse (over and over again) is the secret to virality. (Semafor)
6. China plans to build a moon base by 2028. And it may be powered by nuclear energy. (Bloomberg $)
Bill Nelson, the administrator of NASA, thinks the US should be alarmed by China’s moon explorations. (Politico)
7. Chinese researchers claim they found a way to break quantum encryption. Others are not fully convinced. (Financial Times $)
8. Tom Zhu, Tesla’s China boss, has been promoted to the company’s highest position under Elon Musk. He will oversee the car maker’s global production and deliveries. (Reuters $)
Though it hasn’t been confirmed, a Chinese publication reported last month that Zhu will replace Musk as Tesla’s global CEO. (PingWest)
9. These Chinese women immigrated to the US wishing for better lives. They are now silently suffering from domestic violence in a strange land. (The China Project)
Lost in translation
China’s rural areas are also being ravaged by mass covid infections, and these are places where even basic cold and fever medicine is hard to obtain. As Chinese publication Shanghai Observer reported, while urban residents turn to e-commerce platforms and online self-help groups, seniors living in remote villages have neither the knowledge nor the geographical proximity to benefit from these tech connections.
Instead, a group of volunteers started using spreadsheets to document demand in villages and coordinate delivery of fever medicine. They source the medicine from corporate donations, pharmacies in cities that are better prepared for the surge, and individuals who have extra pills. For their first project, they managed to send 3,000 pills of fever reducer and 2,000 boxes of cold medicine to a village in the western province of Shaanxi. By January 5, an estimated 13,000 senior citizens from 110 villages across the country had benefited from the program.
One more thing
A new video game, Breakout 13, was released by a Chinese indie game studio on Monday. It takes you inside one of China’s internet addiction correction facilities, which infamously use physical abuse and electric shock therapy to “cure” kids who play too many video games or are just too “difficult” to parent. In recent years, indie games have become an increasingly popular way to engage with sensitive topics that can be quickly censored if they appear in traditional cultural forms, like film or music. The game is available to be played in Chinese and English.
Cast your mind back to 2020, if you can bear it. As the year progressed, so did the impact of covid-19. We were warned that wearing face coverings, disinfecting everything we touched, and keeping away from other people were some of the only ways we could protect ourselves from the potentially fatal disease.
Thankfully, a more effective form of protection was in the works. Scientists were developing all-new vaccines at rapid speed. The virus behind covid-19 was sequenced in January, and clinical trials of vaccines using messenger RNA started in March. By the end of the year, the US Food and Drug Administration issued emergency-use authorization for these vaccines, and vaccination efforts took off.
This is an astonishingly fast turnaround for any new drug. But it follows years of research on the core technology. Scientists and companies have been working on mRNA-based treatments and vaccines for decades. The first experimental treatments were tested in rodents back in the 1990s, for diseases including diabetes and cancer.
These vaccines don’t rely on injecting part of a virus into a person, like many other vaccines do. Instead, they deliver genetic code that our bodies can use to make the relevant piece of viral protein ourselves. The entire process is much quicker and simpler and sidesteps the need to grow viruses in a lab and purify the proteins they make, for example.
But while the first approved mRNA vaccines are for covid-19, similar vaccines are now being explored for a whole host of other diseases. Malaria, HIV, tuberculosis, and Zika are just some of the potential targets. mRNA vaccines might also be used in cancer treatments tailored to individual people. Here, the idea is to trigger a specific response by the immune system—one that is designed to attack tumor cells in the body.
Moderna, the biotech company behind one of the two approved mRNA vaccines for covid-19, is developing mRNA vaccines for RSV (respiratory syncytial virus), HIV, Zika, Epstein-Barr virus, and more. BioNTech, which partnered with Pfizer on the other approved mRNA-based covid-19 vaccine, is exploring vaccines for tuberculosis, malaria, HIV, shingles, and flu. Both companies are working on treatments for cancer. And many other companies and academic labs are getting in on the action.
Self-made vaccines
Messenger RNA itself is a strand of genetic code that can be read by your DNA and used to make proteins. The lab-made mRNA used in vaccines can code for a specific protein—one that we’d like to train our immune systems to recognize. In the case of covid-19 vaccines, the code is for the spike protein found on the outer shell of the Sars-CoV-2 virus, which causes the disease. The mRNA itself is packaged up in lipid nanoparticles—tiny little envelopes that help it survive the journey into your body.
The vaccines are cheap, quick, and easy to make, says Katalin Karikó, an adjunct professor at the University of Pennsylvania who has pioneered research into the use of mRNA for vaccines. They are also very efficient. “You put [the mRNA] in cells, and half an hour later, they are already producing the protein,” she says.
The idea is that once your immune system has been exposed to such a protein, it is better placed to mount a strong response should it ever encounter the virus itself. In the case of covid-19, this is thought to be largely due to the production of antibodies—proteins that protect us against infections. Trained-up immune cells play an important role, too.
In theory, we could make mRNA for pretty much any protein—and potentially target any infectious disease. It’s an exciting time for mRNA vaccine technology, and vaccines for plenty of infectious diseases are currently making their way through clinical trials.
Universal protection
It’s tricky to predict exactly which mRNA vaccines might be the next to make it into health clinics. But hopes are high for a flu vaccine. Potentially, a universal vaccine could protect against multiple strains of flu, while protecting against the coronavirus at the same time.
The current flu vaccine works by introducing a protein from the virus to your immune system, which should mount a response and learn how to defeat the virus. But it takes months to grow the virus in eggs to make this protein. The production process has to start in February in order to have a vaccine ready for October, says Anna Blakney, who studies RNA at the University of British Columbia in Vancouver, Canada. Every year, scientists in the Northern Hemisphere guess which strain of flu is likely to take off there by looking at what has happened in the Southern Hemisphere.
These guesses aren’t always spot on, and the flu virus can mutate over time, even while it is in the eggs. As a result, “it’s a notoriously underperforming vaccine,” says Blakney. The flu vaccine used in the US in 2019-2020 was 39% effective, but the one used in the 2004-2005 flu season was only 10% effective, according to estimates from the US Centers for Disease Control and Prevention.
mRNA vaccines, on the other hand, are relatively quick to make. “You could imagine having a one-month turnaround for an RNA vaccine,” says Blakney. By September, scientists should have a much better idea of which flu strain is likely to take off in October and be better placed to target it.
There’s another potential benefit. Scientists can make mRNA vaccines that encode for more than one viral protein—which could allow us to create vaccines that protect against multiple strains of flu. Norbert Pardi at the University of Pennsylvania and his colleagues are working on a universal flu vaccine—one that Pardi believes would protect against every type of flu that can make humans sick. His team recently showed that the vaccine could protect mice and ferrets from 20 flu subtypes. Other labs are working on mRNA vaccines that protect against all coronaviruses.
If we can include the code for several proteins, there’s the possibility to protect against multiple diseases in one shot. Moderna’s vaccine for covid, flu, and RSV is already in clinical trials, for example. In the future, we could go even further—just one or two shots could, in theory, protect you from 20 different viruses, says Karikó.
Cancer vaccines
Before anyone had started developing mRNA vaccines for the coronavirus that causes covid-19, researchers were trying to find ways to use mRNA to treat cancer. Here the approach is slightly different—the mRNA would be working as a “vaccine therapeutic.”
In the same way that we can train our immune systems to recognize viral proteins, we could also train them to recognize proteins on cancer cells. In theory, this approach could be totally personalized—scientists could study the cells of a specific person’s tumor and create a custom-made treatment that would help that individual’s own immune system defeat the cancer. “It’s a fantastic application of RNA,” says Blakney. “I think there’s huge potential there.”
Cancer vaccines have been trickier to make, partly because there’s often no clear protein target. We can make mRNA for a protein on the outer shell of a virus, such as the spike protein on the virus that causes covid-19. But when our own cells form tumors, there’s often no such obvious target, says Karikó.
Cancer cells probably require a different kind of immune response from that required to protect against a coronavirus, adds Pardi: “We will need to come up with slightly different mRNA vaccines.” Several clinical trials are underway, but “the breakthrough hasn’t happened yet,” he adds.
The next pandemic
Despite their huge promise, mRNA vaccines are unlikely to prevent or treat every disease out there, at least as the technology stands today. For a start, some of these vaccines need to be stored in low-temperature freezers, says Karin Loré, an immunologist at the Karolinska Institute in Stockholm, Sweden. That just isn’t an option in some parts of the world.
And some diseases pose more of a challenge than others. To protect against an infectious disease, the mRNA in a vaccine will need to code for a relevant protein—a key signal that will give the immune system something to recognize and defend against. For some viruses, like covid-19, finding such a protein is quite straightforward.
But it’s not so easy for others. It might be harder to find good targets for vaccines that protect us against bacterial infections, for example, says Blakney. HIV has also been difficult. “They’ve never found that form of the protein that induces an immune response that works really well for HIV,” says Blakney.
“I don’t want to give the impression that mRNA vaccines will be the solution for everything,” says Loré. Blakney agrees. “We’ve seen the effects that these vaccines can [have], and it’s really exciting,” she says. “But I don’t think that, overnight, all vaccines are going to become RNA vaccines.”
Still, there’s plenty to look forward to. In 2023, we can expect an updated covid-19 vaccine. And researchers are hopeful we’ll see more mRNA vaccines enter clinics in the near future. “I really hope that in the next couple of years, we will have other approved mRNA vaccines against infectious disease,” says Pardi.
He is planning ahead for the next global disease outbreak, which may well involve a flu virus. We don’t know when the next pandemic will hit, “but we have to be ready for it,” he says. “It’s crystal clear that if you start vaccine development in the middle of a pandemic, it’s already too late.”
This story is a part of MIT Technology Review’s What’s Next series, where we look across industries, trends, and technologies to give you a first look at the future.
We’re back with our annual list of the worst technologies of the year. Think of these as anti-breakthroughs, the sort of mishaps, misuses, miscues, and bad ideas that lead to technology failure. This year’s disastrous accomplishments range from deadly pharmaceutical chemistry to a large language model that was jeered off the internet.
One theme that emerges from our disaster list is how badly policy—the rules, processes, institutions, and ideals that govern technology’s use—can let us down. In China, a pervasive system of pandemic controls known as “zero covid” came to an abrupt and unexpected end. On Twitter, Elon Musk intentionally destroyed the site’s governing policies, replacing them with a puckish and arbitrary mix of free speech, personal vendettas, and appeals to the right wing of US politics. In the US, policy failures were evident in the highest levels of overdose deaths ever recorded, many of them due to a 60-year-old chemical compound: fentanyl.
The impact of these technologies could be measured in the number of people affected. More than a billion people in China are now being exposed to the virus for the first time; 335 million on Twitter are watching Musk’s antics; and fentanyl killed 70,000 in the US. In each of these messes, there are important lessons about why technology fails. Read on.
The FTX meltdown
Night falls on made-up money
Imagine a world in which you can make up new kinds of money and other people will pay you, well, real money to get some. Let’s call what they’re buying cryptocurrency tokens. But because there are so many types of tokens, and they’re hard to buy and sell, imagine that an entrepreneur creates a private stock market to trade them. Let’s call that a “cryptocurrency exchange.” Because the tokens have no intrinsic value and other exchanges have gone belly-up, you’d make sure yours was ultra-safe and well regulated.
That was the concept behind FTX Trading, a crypto exchange started by Sam Bankman-Fried, a twentysomething who touted sophisticated technology, like a 24/7 “automated risk engine” that would check every 30 seconds to see if depositors had enough real money to cover their crypto gambles. Technology would assure “complete transparency.”
Behind the façade, though, FTX was seemingly just old-fashioned embezzlement. According to US investigators, Bankman-Fried took customers’ money and used it to buy fancy houses, make political donations, and amass huge stakes in illiquid crypto tokens. It all came crashing down in November. John Ray, appointed to oversee the bankrupt company, said that FTX’s technology “was not sophisticated at all.” Neither was the purported fraud: “This is just taking money from customers and using it for your own purpose.”
Bankman-Fried, an MIT graduate whose parents are both Stanford University law professors, was arrested in the Bahamas in December and faces multiple counts of conspiracy, fraud, and money laundering.
Back in 1953, the Belgian doctor and chemist Paul Janssen set about creating the strongest painkiller he could. He believed he could improve on morphine, designing a molecule that was 100 times more potent but with a short duration. His discovery, the synthetic opioid fentanyl, would become the painkiller most widely used during surgery.
Today, fentanyl is setting grim records—it’s involved in the accidental death of around 70,000 people a year in the US, or about two-thirds of all fatal drug overdoses. It’s the leading cause of death in American adults under 50, killing more than car accidents, guns, and covid together.
Fentanyl kills by stopping your breathing. Its potency is what makes it deadly. Two milligrams—the weight of a hummingbird feather—can be a fatal dose.
How did we get to nearly 200 deaths a day? Janssen Pharmaceuticals, a division of Johnson & Johnson, played a role. It made false claims about how addictive prescription opioid drugs were, minting money while people got hooked on pills and patches. This year, Janssen agreed to pay a $5 billion settlement without admitting wrongdoing.
Now fentanyl reaches drug users from clandestine labs in Mexico, run by ruthless cartels. It’s used to spike heroin or pressed into counterfeit pain pills. Can things get worse? They can. US states are reporting a rapid uptick in fentanyl deaths in young children who accidentally ingest pills.
For recent reporting on the fentanyl crisis, read “Cartel RX,” a new series in the Washington Post.
A pig heart with a virus in it
Unanswered questions about that historic transplant
Here’s a technology that’s a bona fide breakthrough and a big-time screwup. Last January, surgeons in Maryland transplanted a pig heart into a dying man with heart failure. The organ was genetically engineered to resist rejection by the human immune system. The patient, David Bennett Sr., died two months after the transplant.
No human had ever survived even temporarily with a pig heart before. That part was a massive success. The problem is that the heart harbored a pig virus, one that might have contributed to the patient’s death. It looks as if the company that designed and bred the engineered pigs, United Therapeutics, didn’t test well enough to detect the virus. It’s hard to know for sure, because United swept a veil of secrecy around what happened.
The risk of spreading pig viruses into humans has always been the gravest question about this technology. Martine Rothblatt, the founder of United, even wrote an entire book on the subject. “Every right to make a technology is coupled to an obligation,” she told the podcaster Tim Ferriss in 2020. With pig organ transplants, that obligation is “no risk—not some risk, but no risk” of any kind of animal virus seeping into the human population.
This particular virus, known as porcine cytomegalovirus, isn’t believed to be able to infect human cells. It won’t spawn a deadly pandemic. You might say, “No harm, no foul.” But what about the next time? We need to know how and why the virus slipped through and whether it was part of what killed David Bennett. And so far, no one has offered an explanation.
For two and a half years, China kept the coronavirus in check through a system of quarantine hotels, constant testing, and phone QR codes. A green code meant freedom. A red code meant you’d been near someone with the virus—turning you into an instant pariah, unable to eat in a restaurant or board a plane. China’s leader, Xi Jinping, styled himself the leader of a “people’s war” against the germ.
The system was oppressive—and it worked. China had incredibly few cases of covid. But in December, the government abruptly disbanded the program. Now analysts predict 1 million deaths.
Some observers have linked the reversal to widening dissent over the suffocating policies. In October a bold protester hung a banner from a Beijing bridge. “No to covid tests!” it read. “No to great leader, yes to vote.” Soon lockdown demonstrators around the country had taken up the slogan. Unruly scenes of students and workers demanding change began to spread on social networks.
But the real story may be that China’s suite of anti-covid measures and technologies—once so effective—had finally failed. Mike Ryan, a senior official at the World Health Organization, believes China was tracking widening outbreaks of the easily transmitted omicron variant “long before there was any change in the policy.”
“The disease was spreading intensively because, I believe, the control measures in themselves were not stopping the disease,” says Ryan.
To learn more about daily life under the zero-covid policy, read the travelogue of a scholar visiting China that was published by the Center for Strategic and International Studies.
Elon Musk’s Twitter rules
An absolute monarch tests his powers
When the world’s richest man (at the time) bought Twitter, he promised above all to restore “free speech” to the platform.
Musk fired most of Twitter’s staff and released the “Twitter files”—Slack messages exchanged by former executives as they decided whether to ban Donald Trump or block news about Hunter Biden’s laptop. He insinuated that Twitter’s former head of trust and safety was a secret pedophile. He let controversial figures back on and announced new rules as he went, seemingly on the fly: No parodies. No Instagram links. No posting of public data showing the location of billionaires’ private jets.
Some predicted Twitter’s technology would break under the stress. But what Musk was breaking—violently and suddenly—were the rules of interaction on the site and, therefore, the product itself. “The essential truth of every social network is that the product is content moderation,” wrote the journalist Nilay Patel. “Content moderation is what Twitter makes—it is the thing that defines the user experience.”
The site’s users must now decide whether the new, changed Twitter is one they want. They will deliver the real verdict on Musk’s manic one-man rule as moderator in chief. Six weeks after taking control of the company, Musk, perhaps tiring of the job, put his reign to a vote. “Should I step down as head of Twitter? I will abide by the results of this poll,” he tweeted on December 18.
The result: 57.5% said he should leave, and 42.5% asked him to stay on.
In 2022 there should be a way to sell concert tickets smoothly and transparently, even for large events like the hotly anticipated tour by Taylor Swift. But the world’s largest ticket seller couldn’t get it straight. It bobbled sales for the tour when its system crashed, leaving passionate “Swifties” furious. Then, in Mexico City, more than a thousand Bad Bunny fans had their tickets rejected as fakes—even as the reggaeton star played to a partly empty venue.
Mexico’s consumer protection bureau says it may file a lawsuit. Swift fans in Los Angeles already have, alleging that the “ticket sale disaster” was due to Ticketmaster’s “anticompetitive” practices. Ticketmaster and its parent company, Live Nation, control more than 80% of concert sales in the US, and the company has long been scrutinized by antitrust regulators.
It’s not just that tickets are expensive (buying a so-so seat for Taylor Swift’s tour costs $1,000). According to Yale economist Florian Elderer, lack of competition could account for the ticketing mistakes. “The allegations against Ticketmaster are that it abused its dominant market position by underinvesting in site stability and customer service,” Elderer says. “Thus, rather than causing harm to consumers by charging exorbitant prices, Ticketmaster is alleged to have caused harm by providing inferior quality—which it could not have done had it faced credible competitors.”
Nothing symbolizes Ukraine’s surprising resistance to the Russian invasion better than the sinking of the Moskva, Russia’s Black Sea flagship, in April. The cruiser, bristling with missile tubes, was a floating air-defense system. But on the 13th of April, the ship was hit and sunk by two missiles launched from the shore.
Analysts have pored over the event. The Moskva ought to have been able to see and shoot down the missiles. But there are signs the ship wasn’t ready for a shooting war. It may have been having problems with its aging radars and guns. Half its crew were recent conscripts who officially weren’t even supposed to be fighting. Russia has denied that the ship was even attacked: it says the Moskva sank in bad weather after some ammunition exploded.
To commemorate its resistance, Ukraine’s government printed a memorial stamp, featuring a soldier holding up a middle finger at the warship.
This fall, two large language models—AIs that can respond to questions in fluent, human-like text—were released online for the public to experiment with. Although the two systems were similar, their public reception was anything but.
The model from Meta, called Galactica, survived only three days before furious criticism caused the company to pull the plug. We decided to prompt the surviving model, OpenAI’s ChatGPT (which is getting rave reviews), to tell a story about what happened. Below is our prompt and the model’s response. It took ChatGPT about 25 seconds to compose its answer.
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On December 1, 2019, the first known covid-19 patient started showing symptoms in Wuhan. Three years later, China is the last country in the world holding on to strict pandemic control restrictions. However, after days of intense protests that shocked the world, it looks as if things could finally change.
It’s a confusing time. Instead of a single top-down decision from Beijing to roll back zero-covid policies, there have been many independent decisions announced by local governments in the last week, mostly about canceling mandatory PCR tests and reopening businesses. Yet they sometimes contradict each other, and plenty of Chinese cities are keeping their tight controls.
Lots of people are celebrating the fact that China has finally started pursuing a covid response emphasizing vaccines and treatments instead of quarantines and lockdowns, as the latter strategies hit the Chinese economy hard. But doubts are starting to grow because of a lack of clear messaging from the top.
So in this newsletter I’ll try my best to summarize and explain the different policies.
The speculation started with a vaguely worded top-level speech. On November 30, Sun Chunlan, China’s vice premier, dubbed the “zero-covid czar,” said at a meeting in Beijing that China’s pandemic control is “facing new situations and new tasks” as the omicron variant takes center stage. She didn’t mention “dynamic zero,” China’s overarching policy to eliminate local outbreaks at any cost—thus signaling a change in the works.
In response, at least three provinces and 13 other cities, covering China’s most economically developed regions, have announced changes to their local covid control rules as of Monday, December 5.
Despite the confusingly different language, these changes mostly target one thing: mass PCR testing.
Ever since May 2020, when Wuhan managed to test its whole population of over 10 million in the span of 10 days, China has been conducting mass PCR testing campaigns. The frequency of these campaigns increased this year as omicron spread, and many cities instated mandatory tests for all citizens every two or three days. Without a recent negative test result, people are barred from activities like using public transport or even entering stores, which became a significant burden to their daily lives.
That is finally changing. Many local governments are now replacing mandatory PCR tests with a new regime called “愿检尽检,” or “Those who want to get tested can all get tested.” The requirement for a negative PCR test result is being lifted across China. Cities like Tianjin have removed it for public transport, while it’s been lifted in Shanghai for entering most public venues, and Beijing even waived it for buying drugs in pharmacies.
This has been welcomed by people like Eric, a Guangzhou resident who resisted mass PCR campaigns and suffered from the inconvenience it caused. His health QR code had been yellow for a long time, thus barring him from taking public transport, but it suddenly turned green last week as Guangzhou changed its covid rules.
In fact, his neighborhood committee, which carries out China’s covid policies at the grassroots level, sent him a refreshingly unusual note encouraging people to “take fewer PCR tests and more at-home antigen tests.” The reasoning was that a positive PCR result means the whole building will be locked down, while results from a self-conducted antigen test are not reported to the government.
These recent policy changes don’t affect aspects of China’s pandemic response like the expansive health QR code system and the gigantic central quarantine facilities. But people see them as a direct result of the protests and are welcoming even baby steps toward loosening the rules.
Still, a lot of chaos and unresolved problems remain.
First of all, different areas are doing different things. Beyond the cities that are dropping PCR testing requirements, the majority of China is either maintaining old restrictions or stuck in a confusing limbo. Hefei, a city of over 7 million people in eastern China, said on Sunday that it “can only increase and not decrease the number of PCR testing locations.” Jinzhou, a smaller city, doubled down on lockdowns on Thursday before immediately changing its stance and opening up public venues on Friday. Even among the cities that have relaxed their testing requirements, the rules differ. Some still require tests for entering indoor venues or getting medical services.
As a result of these discrepancies, people still need to take PCR tests if they are traveling between cities with different rules, even though they are told it’s technically not required anymore. Meanwhile, some cities have already started to shut down free PCR testing locations, so now there are longer wait lines and potentially higher costs to take the same tests.
To be honest, with no clear message from the central government, it seems to me that cities are just trying to guess what Beijing will decide later. And as usual, it’s ordinary people who have to accommodate the discrepancies and deal with the uncertainty.
While the protests have wound down, this is only the beginning of the pivot to looser covid restrictions, if China sticks to this path. Abandoning zero covid will not be easy, as the number of cases and deaths will rise, and China’s already weak health-care system will be severely squeezed. By November, only about 40% of Chinese people over 80 had received a booster shot, which studies show can significantly increase the defense against covid. Researchers also estimated that it could lead to 1 to 2 million deaths if China loosened its pandemic measures without also ramping up access to vaccination and treatments.
“At this moment, Xi’s China has become a time machine taking us backwards in time … to the dark days of 2020—first to the drama of Wuhan and then on from there to the horror of Bergamo and New York’s chaotic emergency rooms. Our problems then are China’s problems now, how to weigh up mass casualties against huge economic loss,” writes Adam Tooze, a history professor at Columbia University.
Whatever happens, there needs to be a lot more consistent government messaging and policymaking, and Chinese people will be desperately hoping to see that soon. Reuters reports that China may announce 10 more covid easing measures as early as Wednesday. I’ll update you in the next newsletter.
What do you think will be the biggest obstacle to getting rid of zero-covid policies? Let me know by emailing me at zeyi@technologyreview.com.
Catch up with China
1. Last week I talked to “Teacher Li,” a Chinese painter who had a meteoric rise on Twitter as he became the hub of protest information and footage. (MIT Technology Review)
Xi Jinping addressed the protests for the first time, according to European Union officials who met with him on Thursday. He reportedly blamed them on “frustrated students.” (South China Morning Post $)
2. Former Chinese president Jiang Zemin, who oversaw a decade when China’s economy opened up to the world, died on Wednesday at the age of 96. (BBC)
The government ordered a week of public mourning, during which livestreamers are explicitly instructed to wear formal attires, tone down the entertainment content, and not appear against brightly colored backdrops. (China Digital Times)
3. An Associated Press journalist was beaten and detained by Shanghai police during a protest, and his phone was confiscated. (AP)
4. After a violent protest at a Chinese Foxconn factory that makes iPhones, Apple is reportedly considering moving more manufacturing capacity out of the country and into India or Vietnam. (Wall Street Journal $)
5. The indictment against Meng Wanzhou, Huawei’s CFO and daughter of the company’s founder, has been officially dropped in the US, marking the end of a high-profile diplomatic saga. (Reuters $)
6. A teacher of Mongolian ethnicity protested against China’s cutback on primary school lessons in his mother tongue. Then the government tracked him down, even after he fled to Thailand. (The Economists $)
7. The Chinese surveillance camera company Hikvision is still advertising its ethnicity recognition features to European buyers. (The Guardian)
8. Three Chinese astronauts returned to Earth, while another three were sent up to finish building the country’s space station. (BBC)
Lost in translation
One community that suffered especially heavily from the three-month covid lockdown in China’s northwestern region Xinjiang is livestock farmers, reports Chinese magazine Sanlian Lifeweek. Farmers in Xinjiang have a tradition of seasonal migration, usually taking all their cattle to a different pasture to graze during the winter. But because the farmers were locked down at home, they missed the migration window, and many had to migrate amid snow storms. As a result, many cattle went missing or froze to death. Some counties are even requiring farmers to test negative for covid seven times consecutively in a week before they are allowed to transfer their stock in December.
Farmers who choose not to migrate have to buy a lot of animal feed, which has become significantly more expensive since lockdowns disrupted China’s economy. Having to deal with issues like getting a delivery truck certificate during lockdown and finding workers who are able to leave their homes has made animal feed 60% more expensive than last year.
One more thing
Ever wondered what Jack Ma, the Alibaba founder who paid a hefty price for criticizing China’s fintech regulators, is doing now? Turns out he’s been living in Tokyo the past six months, spending his time painting watercolors and collecting modern art. Before that, he was golfing in Spain and learning about agriculture in the Netherlands. What a nice retirement.
Editor’s note: This is a translation of a story about a Chinese painter based in Italy who became a critical source of information for many in China during recent protests against the country’s zero-covid policy. Find the English language version here.
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The past week has meant many sleepless nights for people in China, and for people like me who are intently watching from afar.
You may have seen that nearly three years after the pandemic started, protests have erupted across the country. In Beijing, Shanghai, Urumqi, Guangzhou, Wuhan, Chengdu, and more cities and towns, hundreds of people have taken to the streets to mourn the lives lost in an apartment fire in Urumqi and to demand that the government roll back its strict pandemic policies, which many blame for trapping those who died.
It’s remarkable. It’s likely the largest grassroots protest in China in decades, and it’s happening at a time when the Chinese government is better than ever at monitoring and suppressing dissent.
Videos of these protests have been shared in real time on social media—on both Chinese and American platforms, even though the latter are technically blocked in the country—and they have quickly become international front-page news. However, discussions among foreigners have too often reduced the protests to the most sensational clips, particularly ones in which protesters directly criticize President Xi Jinping or the ruling party.
The reality is more complicated. As in any spontaneous protest, different people want different things. Some only want to abolish the zero-covid policies, while others have made direct calls for freedom of speech or a change of leadership.
I talked to two Shanghai residents who attended the protests to understand what they experienced firsthand, why they went, and what’s making them anxious about the thought of going again. Both have requested we use only their surnames, to avoid political retribution.
Zhang, who went to the first protest in Shanghai after midnight on Saturday, told me he was motivated by a desire to let people know his discontent. “Not everyone can silently suffer from your actions,” he told me, referring to government officials. “No. People’s lives have been really rough, and you should reflect on yourself.”
In the hour that he was there, Zhang said, protesters were mostly chanting slogans that stayed close to opposing zero-covid policies—like the now-famous line “Say no to covid tests, yes to food. No to lockdowns, yes to freedom,” which came from a protest by one Chinese citizen, Peng Lifa, right before China’s heavily guarded party congress meeting last month.
While Peng hasn’t been seen in public since, his slogans have been heard and seen everywhere in China over the past week. Relaxing China’s strict pandemic control measures, which often don’t reflect a scientific understanding of the virus, is the most essential—and most agreed-upon—demand.
It was really only later that night (or, more accurately, early the next morning, around 3 a.m.), that the chants got more radical and more political, when some people directly called for the Chinese Communist Party and Xi to step down. Zhang had already left by then, but from home he saw videos on social media.
Chen, another Shanghai resident, went to the second protest on Sunday afternoon in the same location and heard much of the same as Zhang. She said that while everyone echoed the demands for relaxing the testing system and increasing freedom, there were some chants explicitly mentioning Xi or the Communist Party. These, she said, were noticeably less loud.
Chen agreed that people have the right to say whatever they want, but she worried that it may divert the public’s attention from what she sees as the core message: “It’s unnecessary to shout out too radical political slogans from the beginning. It’s too radical.”
The people protesting are clearly not a monolith. And, to be fair, it is the first time many of them are participating in a protest in real life; they are just learning how it works. They came out of their homes because they have been genuinely disturbed by the increased covid control measures. Even after the Chinese government announced a policy to loosen restrictions in early November, the reality on the ground hasn’t really changed. In some cities, local government officials have doubled down on controls. When people hit the streets, they might be thinking of the things that are closest to their lives and not what that means on a higher political level.
It’s understandable that the rare direct criticism of China’s top leadership has raised more eyebrows overseas and made it into newspaper headlines. But it has also stirred worries that this organic, homegrown movement will be painted as foreign interference. In fact, that’s already happening. Some Chinese pro-government influencers have highlighted the anti-Xi slogans to claim that foreign actors are pushing a “color revolution.”
(Other protesters argue that the legitimacy of the protests would be doubted regardless of whether the slogans were radical or not. Smearing protesters as foreign actors is an old rule in the Chinese information-control playbook.)
So what’s going to happen next? We don’t know how long the protests are going to continue, but they have become much harder to organize and attend since the Chinese police gradually reacted to the events and increased their enforcement activities.
While Zhang has friends who worry that protesters are being pushed to become more radical as the demonstrations continue, that in particular does not trouble him. He told me he thinks it’s perfectly fine for people to have a range of thoughts and feelings. “[If you don’t agree], you can just choose not to say it,” Zhang said. “In protests, there are always going to be slogans that are too radical. You can either choose peaceful demonstrations and not say anything; or if you are speaking out, then don’t be afraid.”
What does worry him is how China’s well-oiled state surveillance system can be easily deployed against these protesters—an important part of the risk calculation for anyone who has participated and who still wants to go. Zhang read on social media that protesters in Beijing suspect their health code data has been used against them to determine who showed up. There are also reports of police checking people’s phones in Shanghai, which deeply concerned Chen and made her take a different route to work on Monday to avoid the police presence.
Chen said she worries about going to a protest again and ending up alone and falling victim to the police. But she would go if enough people showed up; she wants to, because the experience of the past days has taught her that protests really matter.
Back in October, when Peng Lifa staged that single-person protest, Chen thought it would go unnoticed. But seeing so many people in different cities chanting the same words that Peng wrote has convinced her that protests, no matter how small, can get the message across in today’s China. “These fights have meaningful results,” she said. “The [results] may not show up the next day, but they will.”
1. What else you need to know about the protests in China:
A Uyghur living in exile confirmed that five of his relatives died in the Urumqi fire, which inspired the nationwide protests. (AP)
Twitter, with its massively reduced anti-propaganda team, is struggling with the rise of porn spam that has obscured search results on what’s happening in Chinese cities. (Washington Post $)
Blank sheets of white paper have become the new protest symbol. (Wall Street Journal $)
Last week, in a separate but related protest, workers in a Foxconn factory in China clashed, sometimes violently, with security forces over salary changes and covid-infection concerns. (CNN)
2. China plans to revise its antitrust law, adding many new rules targeting tech platforms. (South China Morning Post $)
3. Four Chinese immigrants working on a marijuana farm in Oklahoma were recently killed. (NBC News)
While it’s too early to know if it was the case in this incident, during the pandemic thousands of Chinese immigrants living on the West Coast were lured and trafficked to cannabis farms in New Mexico, Oklahoma, and the Navajo Nation. (Searchlight New Mexico)
4. The Vatican was taken by surprise by the installation of a bishop in China in a diocese that the church does not recognize. (Vatican News)
5. Serbian police bought and used Huawei-made surveillance equipment to identify fugitives and record videos of protesters. (Radio Free Europe)
6. Chinese company Sino Biopharm announced it has successfully developed three mRNA vaccines to prevent monkeypox. (News Medical)
7. Popular video games like World of Warcraft and Overwatch will no longer be playable in China after a deal between Activision Blizzard and the Chinese company NetEase fell through. (BBC)
8. China may be the biggest climate polluter today, but data shows the US is responsible for the most emissions throughout history. (MIT Technology Review)
Lost in translation
When three Chinese artists found themselves in a centralized quarantine facility in Sichuan, they decided to turn eight days in solitary into an art experiment.
As Chinese publication Bingdian Weekly reported, Meng Lichao, Chen Yu, and Yang Yang were supposed to attend an art festival in early November, but a last-minute covid case in the hotel where they were staying meant all three artists had to be transferred to a quarantine facility. Since they were missing the festival, they decided to put up art exhibitions in their individual rooms instead. Meng drew doodles over every inch of the walls and made an audio installation mixing EDM music and audio samples that say “You are being monitored.” Chen printed out surveillance camera footage of fellow residents opening their doors without management’s approval that had been shared in an attempt to publicly shame them. Yang made a collage on the wall with medical waste trash bags, cotton swabs, and food packaging from his quarantine meals.
In the end, since it’s a quarantine facility, no one could come in to see the art in their rooms except for the next batch of residents, who arrived just hours after they left.
One more thing
Who says you can’t find peace and serenity in your phone? Young Chinese people are using apps that simulate “wooden fish”—a special woodblock that Buddhist monks knock rhythmically in ceremonies—to purify themselves of sins and acquire “merit scores.” Well, most of the time it’s more of a tongue-in-cheek joke for these people than a serious religious practice. But app developers have since come up with different variations of digital wooden fish, sometimes gamifying the practice and allowing users to compete with friends for the highest merit score.
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Welcome back to China Report!
I recently had a very interesting conversation with Wall Street Journal reporters Josh Chin and Liza Lin. They wrote a new book called Surveillance State, whichexplores how China is leading the global experiment in using surveillance tech.
We covered a lot of important topics: how covid offered the ideal context to justify expanding government surveillance, how the world should respond to China, and even philosophical questions about how people perceive privacy. You can read the takeaways in full here.
But in this newsletter, I want to share a few extra snippets from our conversation that have really stuck with me.
Chin and Lin are very clearheaded about the fact that the emergence of the surveillance state is not just a problem in China. Countries with democratic institutions can be and have already been attracted to surveillance tech for its (often artificial) promises. Singapore, where Lin is from, is a great example.
When Lin was living in Shanghai in 2018, she used to count the number of surveillance cameras she would see every day. As she told me:
I remember one day walking from my apartment to Lao Xi Men station in Shanghai, and there were 17 cameras just from the entrance of that subway station to where you scan your tickets. Seventeen cameras! All owned by various safety departments, and maybe the metro department as well.
She thought this phenomenon would be unique to China—but when she later moved back to Singapore, she found out she was wrong.
Once I started going back [to Singapore] in 2019 and 2020, it [had] started to embrace the same ideas that China had in terms of a “safe city.” I saw cameras popping up at road intersections that catch cars that are speeding, and then you saw cameras popping up at the subway.
Even her son has picked up her habit, but this time in Singapore.
He “is now counting the number of cameras when we walk through the subway tunnel just to get to the station,” Lin says. “He’s like, ‘Mommy, that’s the police.’”
We also talked about the impact of the pandemic on surveillance tech. In China, tracing the virus’s spread became another justification for the government to collect data on its citizens, and it further normalized the presence of mass surveillance infrastructure.
Lin told me that the same kind of tracking, if to a lesser extent, happened in Singapore. In March 2020 the country launched an app called TraceTogether, which uses Bluetooth to identify close contacts of people who tested positive for covid. In addition to the mobile app, there were even Apple Watch–size gadgets given to people who don’t use smartphones.
Over 92% of the population in Singapore eventually used the app. “They didn’t say it was compulsory,” Lin told me. “But just like in China, you couldn’t enter public places if you didn’t have that contact tracing app.”
And once the pandemic surveillance infrastructure was in place, the police wasted no time in taking advantage of it.
Chin: I thought this was really telling. Initially, when they rolled it out, they were like, “This will be strictly for health monitoring. No other government agencies are going to have access to the data.” That includes the police. And they made an explicit promise to get people to buy in. And then, I can’t remember how much longer …
Lin: Within that same year.
Chin: Yeah, within the same year, the police were using that technology to track suspects, and they basically openly said: “Well, we changed our minds.”
Lin: And there was a public pushback to that. And now they stopped doing it. It’s just an example of how easily one use can lead to another.
The pushback led the Singaporean parliament to pass a bill in February 2021 to restrict police use of TraceTogether data. State forces are still able to access the data now, but they need to go through a stricter process to get permission.
It’s easy to imagine that not all countries will respond the same way. Several Asian countries were at the forefront of adopting covid tracing apps, and it’s not yet clear how the relevant authorities will deal with the data they collected along the way. So it was a pleasant surprise when I read that Thailand, which pushed for its own covid app, named MorChana, announced in June that it would close down the app and delete all relevant data.
Since our conversation, I keep thinking about what the pandemic has meant for surveillance tech. For one thing, I think it helped illustrate that surveillance is not an abstract “evil” that all “good” societies would naturally object to. Rather, there’s a nuanced balance between privacy and social needs like public health. And it’s precisely for this reason that we should expect to see governments around the world, including democracies, keep citing new reasons to justify using surveillance tech. There will always be some sort of crisis to respond to, right?
Instead of relying on governments to be responsible with data and self-correct when it makes mistakes, Chin and Lin argued, it’s important to start recognizing the harm of surveillance tech early, and to craft regulations that safeguard against those dangers.
How do you think countries should approach surveillance tech? Let me know your thoughts at zeyi@technologyreview.com
Catch up with China
1. Using the medical records of Li Wenliang, the Chinese doctor and covid whistleblower who died in Wuhan in February 2020, reporters were able to reconstruct his final days. They confirmed that doctors were pushed to use excessive resuscitation measures in order to show that his care was not compromised. (The New York Times $)
2. The Biden administration will block international companies, not just American ones, from selling advanced chips and relevant tools to certain Chinese companies. (Reuters $)
Of course, Chinese companies will look for workarounds: already, a startup run by a former Huawei executive is building a semiconductor manufacturing factory in Shenzhen. It may help Huawei circumvent US chip export controls. (Bloomberg $)
On Monday, $240 billion in Asian chip companies’ stock market value was wiped out as traders predicted the new controls will hurt their sales. (Bloomberg $)
The chip export control is the latest in a series of administrative actions intended to restrict China’s efforts to advance in critical technologies. I wrote a primer last month to help you understand them. (MIT Technology Review)
3. Chinese electric-vehicle companies are hungry for lithium mines and spending big bucks around the world to secure supply. (Tech Crunch)
4. Social media influencers are persuading young parents in China to take drastic measures to ensure that their babies conform to traditional beauty standards. (Sixth Tone)
5. The almighty algorithms of Douyin, China’s domestic version of TikTok, are failing to understand audio in Cantonese and suspending live streams for “unrecognized languages.” (South China Morning Post $)
6. To reduce its dependence on China for manufacturing, Apple wants to make its flagship iPhones in India. (BBC)
Lost in translation
Since 2015, banks and fintech platforms have popularized the use of facial verification to make payments faster and more convenient. But that’s also come with a high risk that facial recognition data could be hacked or leaked.
So it’s probably to no one’s surprise that “paying with your face” has already gone quite wrong in China. The Chinese publication Caijing recently reported on a mysterious scam case in which criminals were able to bypass the bank’s facial recognition verification process and withdraw money from a victim’s account, even though she didn’t provide her face. Experts concluded that the criminals likely tricked the bank’s security system through a combination of illegally obtained biometric data and other technical tools. According to local court documents, identity documents, bank account information, and facial recognition data are sometimes sold on the black market at the price of just $7 to $14 per individual account.
