shameful dis-ease: over the counter cold meds and covid

Body shaming and its ills are familiar: eating disorders in the pursuit of an ideal body-type; feelings of inadequacy and low self esteem caused by fat-phobic, misogynistic, racist and anti-trans bullying; and the intense pain and despair that come from being isolated from those around us simply because of who we are. Indeed, shame is an important component of social control precisely because it shifts responsibility for indifferent and cruel treatment of others from the shamer to the shamed. The logic is insidious, direct and more often than not internalized before we finish elementary school: I am treated like shit because this body is fat/ ugly/ female/ trans/ black/ old…

Recently, I’ve realized that mandatory covid testing manipulates body shame to achieve political and social goals. It has also changed previous expressions of care for family and friends.

Inquiring minds want to know: How does zero-covid play upon extant forms of body shame in Shenzhen? Well, if you lived through the US AIDS epidemic in the 1980s and 1990s, you have (because you read Susan Sontag) a pretty good understanding of how illness and shame work to prevent the ill from receiving necessary care, while allowing the healthy and the powerful to justify their indifference to the pain of others. Below, I track how regulation of over the counter cold medicines is part of a bio-governance regime that has made it shameful to catch a cold.

On March 16, as part of its ongoing efforts to maintain zero-Covid, Shenzhen circulated regulations for purchasing 39 over-the-counter medicines for colds and fever. In practice the regulations are as elsewhere proof of a negative corona test taken within the past 48 hours and a green national travel pass (no stars). In addition, the person who purchases the medicine must supply the following information: full name, temperature, ID card number, telephone number, address and list of medicines purchased. Moreover, the pharmacist must confirm the condition of the person for whom the medicine is purchased before it can be brought home and used.

The medicines on the list include Chinese medicines such as a mix of Vitamin C+Honeysuckle VC银翘 to chemical pharmaceuticals that include non-essential amino acids. In other words, these medicines are basically used to boost immune systems, when people are sniffling and sneezing. None are used to treat elevated temperatures or more serious conditions. However, since elevated temperature has been institutionalized as a signifier of a possible covid infection, it is no longer possible self-treat the common cold.

Before zero-Covid conflated physical, social and political health, immune boosters were popular throughout Shenzhen. I used to purchase packets of VC-Honeysuckle, taking them with me when I traveled during the winter months. I shared them with friends who had scratchy throats or a bit of nasal drip. And yes, when I was feeling slightly under the weather, I took similar medicines that friends pulled out of a purse and offered with a cup of tea. Indeed, the sharing of these self-help medicines was part of the language of everyday care precisely because catching a cold was considered a normal part of everyday life. To use the language of covid; we used to ‘co-exist’ 共存 with flu. Catching a cold was normalized through expressions of care, including sharing self-help cures and immune boosters.

Now, however, even if catching a cold hasn’t been criminalized, nevertheless it has been institutionally identified as suspicious behavior. In practice, if a person comes down with the flu, the safest course of action is to stay at home, hiding symptoms and avoiding test stations until the fever passes. The danger, of course, is that if the illness escalates, then one still has to go to the hospital, where it is possible to be shamed for not having reported the condition earlier.

Last year, for example, before widespread mandatory testing began, I came down with a virus that knocked be out for a week. I had a low-grade fever, my muscles ached and I had no appetite. I took aspirin and a few (most likely expired) medicines that we had around the house, but did not purchase anything else to ease the body’s discomfort. After the virus passed, I went about my business as usual, but only mentioned the illness to a few trusted friends because even if I knew that getting sick wasn’t a threat to the social order, nevertheless I was ashamed that my body wasn’t perfect. This feeling was different from pre-covid bouts with the flu, when I told friends, took their home remedies, and went to work. Sometimes masked, but often not. Indeed, then my willingness to work through a cold was interpreted as a sign of my commitment to the group’s well-being, rather than a selfish desire to take a day off. And yes, there were all sorts of problems with that bio-regime as well, including resentment that it was shameful to stay home and take a sick day.

Feeling shame is painful. It isolates and punishes individuals for existing. However, as a form of social control, shame works because it operates on the magical belief that if I change my actions then others will change how they treat me. But there’s the rub. We know that this isn’t true. There are those who care for us and those who refuse to care for us and their position is beyond our personal control. We also know that it is easier to blame individuals rather than a cultural system for inequality; we want to believe that people get what the deserve. And thus, if a person dies because a hospital refuses them entry because their covid passport was out of date, well its their own fault and they should be ashamed.

Thought du jour: in a society where people aspire to ‘reflect on their actions without shame’ 问心不亏, zero-Covid operationalizes shame to achieve political goals. At the same time, precisely because bodies come as they are, experience illness, and inevitably stop working it is all too easy to blame patients rather than policies for school closures, bankrupt business and general frustration. Suddenly, a cough is not a cough, but deliberate anti-social behavior that requires the kind of surveillance that caused the shame in the first place…

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