The novel coronavirus—officially known as COVID-19 by the World Health Organization as of Tuesday—is gaining altitude. The mysterious flu-like respiratory illness that has wracked eastern China and put the rest of the world on alert is creeping into the country’s mountainous western provinces high on the Tibetan Plateau. While the number of cases in these areas still remains low, there has been a slow uptick in infections in recent days, and the weak public health infrastructure in these poor regions could worsen the pandemic.
According to the WHO, the westernmost provinces of Xinjiang, Tibet and Qinghai collectively have 78 confirmed cases so far—up from 27 at the start of February. Sichuan province, which includes the easternmost portion of the Tibetan plateau, has 436 confirmed infections. These vast regions of Western China, sometimes colloquially called the ‘roof of the world’ because of their high elevation, are home to thousands of glaciers.
Globally, over 60,000 people are known to have been infected with COVID-19, and more than 1,300 of them have perished since the disease first appeared in late December. Most of these infections have occurred in central China, specifically Hubei province, where the virus is believed to have originated. Officials think that COVID-19 spilled over from an animal of some kind at a live wildlife market in Wuhan, a city of 11 million. It’s reservoir host—where it persists in the environment—is unknown, although the WHO suspects it to be a species of Rhinolophus bat common throughout Asia.
The biggest worry in the western provinces is containing the virus’s spread. This is a concern across all of China—and of any country during an outbreak—but it carries extra weight in the remote mountainous regions of the country where public health infrastructure is poor and ill-equipped to deal with a large epidemic. In villages and towns scattered across the rugged terrain of the Tibetan plateau, proper hospitals or clinics are hard to come by.
“In the local communities, there aren’t a lot of clinics or things like that. Normally just local doctors, but not a lot,” Huatse Gyal, a cultural anthropologist from the University of Michigan, told GlacierHub. If many sick people from the rural areas came flooding to the county seat in search of treatment, he explained, “the medical facilities would not be enough at all.”
Gerald Roche, an anthropologist from La Trobe University in Australia who lived and studied on the Tibetan plateau for nearly a decade, expressed a similar sentiment. “Healthcare migration is a fact of life for the vast majority of Tibetans,” he told GlacierHub. “The more serious a condition is, the further one has to travel.”
In Qinghai and the Tibetan parts of Sichuan, roads between counties have been closed and checkpoints between townships have sprung up. Many businesses are shuttered and people have been encouraged to stay home. Villages have largely isolated themselves from the outside. “These places aren’t technically on lock-down but it is very far from business as usual,” said Roche.
The remoteness of local communities in the western provinces could work in their favor, however, in spite of a delicate healthcare system. Viruses like the novel coronavirus require large, densely packed populations of people that are regularly in flux in order to persist. “Since the communities live dispersed in these areas, it would be hard for the virus to spread fast,” said Gyal.
The other positive, he pointed out, is the current level of awareness of the disease in these provinces. The ubiquity of phones and social media—even in some of the most remote areas of Tibet—have contributed to a high level of consciousness about the virus and its dangers. “It used to be quite difficult to disseminate this kind of information to these areas,” said Gyal. Social media apps like WeChat and Kuaishou have changed this. “I’ve been in contact with some Tibetan pastoralists and they are fully aware of this,” he said.
Tibetan celebrities have even helped spread knowledge of the disease—especially singers. Several songs are dedicated to coronavirus victims in Wuhan, while others educate listeners about COVID-19 itself— “the lyrics are about the virus,” said Gyal.
Coincidentally, COVID-19 has also made it to a glacier region outside of China as well: the French Alps. The coronavirus cases in France—11 in total—are clustered in Contamines-Montjoie, immediately below the peak Aiguille des Glaciers. The virus has so far jumped from China to 24 countries, largely through air travel, resulting in 441 reported cases and one fatality.
When the epidemic will peak remains unclear, but at the moment it shows no signs of slowing down. After expanding their diagnostic tools for counting new infections, Chinese authorities reported nearly 15,000 new cases and over 240 deaths on Thursday. A stalling economy is putting pressure on authorities to get 700 million of its citizens back to work, however, which could create more conditions for the virus to spread.
From what he can gather from family and friends, Gyal believes the mood among Tibetans to be stable. “I think people are relatively calm,” he said. “But it depends—it’s day to day. It’s been spreading quite fast, so who knows.”