By Yifeng Troy Cai, Brown University
“Any breakthroughs on the ‘extraordinary medicine’ yet? Not even in the U.S.? How about vaccines? When can we start using it?” My informant was disappointed when I told him there was no “extraordinary medicine” for COVID-19 yet, nor would any vaccine be ready for the public anytime soon.
In Chinese, “extraordinary medicine,”特效药 (te xiao yao), refers to medicine that has extraordinary effects on a specific disease. Since January 2020, “extraordinary medicine” has become a staple in the linguistic repertoire of everyday life in China. What my informant and others express through their persistent (re)quest for “extraordinary medicines” is a dissatisfaction with the currently available treatment protocols. They are considered too slow, gradual, imperfect, and, indeed, ordinary.
As early as the end of January, soon after the national lockdown was announced, “extraordinary medicine” had already caught people’s attention in China. Dr. Wang Guangfa, a member of the COVID-19 expert team in China, publicly announced that Kaletra, an antiretroviral medicine for HIV/AIDS, cured his COVID-19-induced fever overnight. He was soon discharged after being tested negative twice for SARS-CoV-2 (Ni 2020). The purported effectiveness of Kaletra was also backed up by the Shanghai CDC’s Dr. Lu Hongzhou, who also claimed that his team had used Kaletra to effectively treat COVID-19 (Xinlang Tech 2020).
Gay men in China—my main informants—were among the first to act on this announcement, due to their relative familiarity with antiretroviral medication. In fact, by the time claims about Kaletra caught other people’s attention, many gay men in China had already been stocking up on this prescription drug and other medicines for HIV/AIDS through online vendors or from drugstores in Thailand or India. Some even started taking them in an attempt to prevent contracting SARS-CoV-2. It was soon discovered, however, that not only did Kaletra have no detectable effects in treating COVID-19, it might in fact slow down recovery and lead to side effects (Ni 2020).
In this light, it appears uncanny that a 2011 movie called Contagion makes a rather accurate prediction about a situation like that of COVID-19 (Karlamangla 2020). In the movie, the British actor Jude Law plays the role of a blogger who partners with big pharma and makes a false claim on social media that forsythia is the cure for a deadly infectious disease called MEV-1. Soon afterwards, people start waiting in long lines in drug stores to purchase forsythia and even resort to burglary and violence to obtain this supposedly life-saving medicine. Many die, both from cross-infection in crowded drug stores and from physical violence.
What is more uncanny is how this movie plot became reality on the other side of the Pacific Ocean in China. On January 31, 2020, the Wuhan Institute of Virology and the Shanghai Institute of Materia Medica made a joint statement that a traditional Chinese medicine (TCM) called Shuang Huang Lian (双黄连) could effectively hinder SARS-CoV-2. Shuang Huang Lian contains three main plant-based ingredients: honeysuckle, Chinese skullcap, and forsythia. Immediately, this statement went viral on the internet and across social media platforms, and was reposted even by governmental outlets such as People’s Daily. Although this statement was released in the evening, people rushed to drug stores and waited in line on the cold winter nights. Within a matter of a couple hours, this TCM was out of stock in physical and online stores. The urge for the extraordinary medicine was so intense that even medicines for livestock containing the same ingredients were quickly sold out for human consumption (Li et al. 2020).
The stockpiling of medicines assumed to have extraordinary effects in preventing the disease led to human costs for those actually sick with conditions now deemed unimportant compared to COVID-19, such as kidney failure, HIV/AIDS, cancer, or psychiatric diseases. For some people, these medicines are ordinary yet life-saving drugs they need on a daily basis for their conditions (Torres 2020). When they became extraordinary in the COVID-19 response, these medicines quickly went out-of-stock and their prices skyrocketed. The promise of extraordinariness—supposedly miraculous life-saving effects—ended up threatening the life and well-being of many.
Such a fervent anticipation and search for “extraordinary medicine” also reveals a deeply-rooted and disproportionate emphasis on treatment and cure over prevention and “preparedness” in global health (Lakoff 2017). As one of my informants, a director at a leading NGO for gay men and male sex workers in China commented, “Why do people always think that it’s so easy to produce ‘extraordinary medicines’? HIV/AIDS has been around for about thirty years now, and there’s still no ‘extraordinary medicine.’ People always think that our services of testing, researching, and monitoring are a complete waste of money. It’s just like the Chinese saying, ‘one who doesn’t think ahead will have to worry soon’.”
This director’s view was not shared by all amidst the outbreak. Rather, the hope of finding extraordinary medicine was persistent and fervent. In China, there are currently over 270 registered clinical trials for different treatments and medicines for COVID-19. Due to the intense competition for participants, many such trials have failed to reach a satisfactory sample size for their studies (MIT Technology Review 2020). Among them is a medicine called Remdesivir, produced by the U.S.-based pharmaceutical Gilead. Originally produced for general antiviral purposes and tested for various infectious diseases such as SARS, MERS, and Ebola, Remdesivir was used to treat the first COVID-19 patient in the U.S. The patient’s condition improved overnight (Joseph, 2020). Despite the rocky trajectory this medicine has had in clinical trials in the past, and although it is currently still unapproved by the FDA, this extraordinary result prompted the Wuhan Institute for Virology to apply for a patency for the use of Remdesivir on COVID-19 and to launch its own clinical trial (Lv 2020). Soon, Remdesivir saturated all sorts of media outlets—so much so that it was nicknamed in China as “People’s Hope” (人民的希望, ren min de xi wang) because of their similar pronunciations. Ironically, People’s Hope was drowned by people’s hope.
Nevertheless, the hope persists. Obsession with and faith in the extraordinary has started to prompt a critical reflection on and even challenge to science and ethics. As one of my acquaintances insists, “Not everything can be explained by science! Even if a random person on the street claims that they have a cure, however unscientific it sounds, we have to give it a try! Nothing works so far! That’s a matter of saving human life. It’s the ethical thing to do.”
But my informant wasn’t precisely right. Not only do existing public health protocols work, up to the point this article was written, over 309 thousand patients have already recovered (Worldometer, 2020). And the number of those recovering will continue to grow. Despite this success, gradual, relatively slow, and “mundane” successful cases seem only to serve as the backdrop against which people judge “miracles” that are not always explained by science (Zhan 2001).
In China and elsewhere, many people, just like my informant, continue to anticipate fast-tracked procedures which either shorten or entirely evade clinical trials in order to find and produce “extraordinary medicines” and vaccines. Moving from one candidate to another, the search for extraordinary medicine continues. There is nothing wrong with seeking an effective treatment for a rapidly spreading infectious disease, but one must reckon with the human and social costs—too easily brushed aside as acceptable collateral damage, or even justifiable sacrifices for the greater good—that such a fervent obsession with the extraordinary entails. That is, what happens when an obsession with extraordinary medicine for one disease renders other forms of social suffering mundane and ordinary?
Yifeng Troy Cai is a PhD candidate in anthropology and MPH candidate at Brown University, whose research interests include medical anthropology, queer studies, STS, and exchange theory. Cai’s research has been funded by the Wenner-Gren foundation, American Council of Learned Societies, among others.
Karlamangla, S. (2020, March 11). How the makers of “contagion” saw an outbreak like coronavirus coming. Los Angeles Times. Retrieved from https://www.latimes.com/california/story/2020-03-11/coronavirus-contagion-outbreak-accuracy-movie
Lakoff, A. (2017). Unprepared: Global health in a time of emergency. Berkeley: University of California Press.
Lv, J. (2020, February 5). Why the Wuhan Institute for Virology can apply for patency for Gilead’s Remdesivir (武汉病毒所为何能抢注申报瑞德西韦的专利). Wangyi Tech. Retrieved from http://tech.163.com/20/0205/12/F4KF888800097U81.html.
MIT Technology Review. (2020, February 28). Remdesivir doesn’t has enough samples, “people’s hope” drowned in 271 research projtects (瑞德西韦遭遇患者样本不足, “人民的希望”淹没在271项研究中) Retrieved from http://www.mittrchina.com/preview/news/4857.
Torres, S. (2020, March 25). Stop hoarding hydroxychloroquine. Many Americans, including me, need it. Washington Post.
Zhan, M. (2001). Does it take a miracle? Negotiating knowledges, identities, and communities of traditional Chinese medixcine. Cultural Anthropology, 16(4), 453–480.
 人无远虑, 必有近忧 (ren wu yuan lü, bi you jin you).