Features
A winter surge of Respiratory Infections sweeps across China
by Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lond),
FRCPCH(UK), FSLCPaed, FCCP, Hony. FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
Joint Editor, Sri Lanka Journal of Child Health
Section Editor, Ceylon Medical Journal
Past President, Sri Lanka Medical Association (2013).
Founder President, Sri Lanka College of Paediatricians (1996-97)
There is considerable global concern regarding the current escalation of respiratory infections in China. Of course, the main reason for worldwide apprehension on the present situation is linked to the everlasting memory of COVID-19 pandemic that was claimed to have originated in China and caused havoc and mayhem right across the globe. The memories of the dire effects of that miserable virus are quite fresh in the mind of the entire planetary population.
This time however, as winter gripped China, that entire nation is made to grapple with a surge in respiratory infections, a confluence of viruses and bacteria overwhelming their healthcare systems. It is reported that all health services in China are tried to the extreme maximum and stretched to the limit. While COVID-19 still remains quite a concern in China, it is now joined by a formidable cast of microorganisms or bugs, including influenza, respiratory syncytial virus (RSV), adenovirus, rhinovirus, human metapneumovirus (HMPV), and Mycoplasma pneumoniae. The last-mentioned mycoplasma organism is a somewhat strange bacterium that is known to cause significant lung infections, especially in children and the elderly. However, it is the only one out of that entire lot against which there are effective antibacterial therapies.
In the face of evolving information about human infections being caused by this plethora of different organisms, the present situation in China, aptly described as a huge storm of many types of respiratory infections, has now sparked fears of a widespread health crisis in that country. That would concomitantly lead to shivers down the spines of inhabitants of many other countries, especially in view of the memories of the terrible consequences that followed COVID-19.
The present wave of chest infections in China is a stark reminder of the ever-evolving nature of respiratory illnesses. While COVID-19 dominated headlines for quite a few years, the recent easing of restrictions has also allowed other viruses and bacteria to resurge. The current respiratory infection surge in China is a complex phenomenon driven by multiple pathogens.
Of all these bugs that are causing havoc in China, influenza is well-known to be perennial winter threat, and remains as a very significant player. Both influenza A and B strains are circulating, causing fever, cough, sore throat, and muscle aches. In severe cases, influenza can lead to pneumonia and even death, particularly among the elderly and those with underlying health conditions. Respiratory Syncytial Virus, primarily affects young children, has the potential to cause mild cold-like symptoms to severe bronchiolitis and pneumonia. Its resurgence has overwhelmed paediatric wards in many parts of China. Adenoviruses are also known to cause problems in children, leading to a range of illnesses, from mild respiratory infections to severe pneumonia as well as eye involvement in the form of conjunctivitis. Rhinovirus, the most common cause of the common cold, can contribute to the overall burden of respiratory infections. There are major concerns regarding the Human Metapneumovirus. Often overlooked, HMPV can cause symptoms similar to the flu, including fever, cough, and difficulty breathing. However, it poses a particular risk to infants, young children, and the elderly, in whom it could go on to a life-threatening illness. Mycoplasma pneumoniae can cause a type of pneumonia known as “walking pneumonia,” characterized by a persistent cough and mild fever but we cannot forget that in some cases the illness becomes quite severe.
The timing of this surge coincides with the onset of winter in China, a period when respiratory infections are typically more prevalent. Cold weather can weaken the immune system, making individuals more susceptible to infection. In the Western countries that have winter weather, respiratory infections are quite common but has not assumed the proportions that are presently seen in China. Additionally, in many countries, including China, the prolonged period of COVID-19 restrictions may have weakened population immunity to other respiratory pathogens as well, contributing to the severity of the current wave in China.
As indicated above, certain groups are particularly vulnerable to severe illness from these infections. In young children the immune systems are still developing, making them more susceptible to severe infections from all kinds of viruses. The elderly have already weakened immune systems as well as other underlying health conditions that put them at increased risk of severe illness and complications. Individuals with chronic health conditions, including young and the middle-aged who are afflicted by asthma, diabetes, and heart disease are more likely to experience severe complications from respiratory infections. Pregnancy too can weaken the immune system, making pregnant women more susceptible to severe illness.
The relentless surge in sheer numbers of affected people has put a significant strain on China’s healthcare system. Hospitals are overflowing with patients, and medical staff are working tirelessly to provide care. This has led to concerns about the quality of care and the potential for further strain on the system. The current situation in China serves as a stark reminder of the importance of preparedness for epidemics of respiratory infections. It highlights the need for robust surveillance systems, access to vaccines and antiviral medications, and strong public health measures to mitigate the impact of these infections.
All these causative organisms spread to humans through the nose and the respiratory tract and the majority of them are exquisitely infectious, thereby leading to rapid spread of the diseases caused by them. One cannot help but reiterate the mantra of the usefulness of wearing masks, avoiding crowded places, maintaining reasonable distances from others and scrupulous washing of hands as time-tested means of preventing respiratory infections. Preparedness and proactive public health measures are crucial to mitigate the impact of future respiratory infection outbreaks. This aspect is particularly important for countries like Sri Lanka as the modern-day fast air travel could make it not too difficult for these infections to come into the country. It calls for cat-like vigilance on the part of our health authorities to enable them to act decisively when the occasion demands it.
As winter progresses, it remains crucial to monitor the situation closely and implement measures to protect vulnerable populations. By staying informed and taking precautions, we can help mitigate the impact of this ongoing health challenge. There is no cause for alarm as yet for us in this Pearl of the Indian Ocean but we need to follow the adage that “a stitch in time saves nine.”
Features
Trump-Xi meet more about economics rather than politics
The fact that some of the US’ topmost figures in business, such as Tesla chief Elon Musk and major US chipmaker Jensen Huang of NVIDIA fame, occupied as nearly a prominent a position as President Donald Trump at the recent ‘historic and landmark’ visit by the latter to China underscores the continuing vital importance of business in US-China ties. Business seemed to outweigh politics to a considerable degree in importance during the visit although the political dimension in US-China ties appeared to be more ‘headline grabbing’.
To be sure, the political dimension cannot be downplayed. For very good reason China could be seen as holding the power balance somewhat evenly between East and West. The international politics commentator couldn’t be seen as overstating the case if he takes the position that China could exercise substantial influence over the East currently; that is Russia and Iran, in the main. The latter powers hold the key in the Eastern hemisphere to shaping international politics in the direction of further war or of influencing it towards a measure of peace.
For example, time and again China has prevented the West from ‘having its own way’, so to speak, in the UN Security Council, for instance, in respect of the ongoing conflicts involving Russia and Iran, by way of abstaining from voting or by vetoing declarations that it sees as deleterious. That is, China has been what could be seen as a ‘moderating influence’ in international politics thus far. It has helped to keep the power balance somewhat intact between East and West.
At present a meet is ongoing between Chinese President Xi Jinping and Russian President Vladimir Putin in Beijing. This happened almost immediately after the Trump visit. Apparently, Beijing is in an effort to project itself as treating the US and Russia even-handedly while underscoring that it is no ‘special friend’ of the US or the West.
This effort at adopting a non-partisan stance on contentious questions in international politics is also seen in Beijing’s policy position on the Hormuz tangle and issues growing out of it. The Chinese authorities are quoted as saying in this regard, for instance, that China is for ‘a comprehensive and lasting ceasefire in the Middle East’.
Such a position has the effect of enhancing the perception that China is even-handed in its handling of divisive foreign policy posers. It is not openly anti-West nor is it weighing in with Iran and other Eastern actors that are opposed to the West in the West Asian theatre. A ‘comprehensive and lasting ceasefire’ implies that a solution needs to be arrived at that would be seen as fair by all quarters concerned.
On the highly sensitive Taiwan issue, President Xi was comparatively forthright during the Trump visit, but here too it was plain to see that Beijing was not intent on introducing a jarring, discordant note into the ongoing, largely cordial discussions with Washington. On the Taiwan question President Xi was quoted saying: ‘If mishandled, the two nations could collide even come into conflict.’ In other words, the US was cautioned that China’s interests need to be always borne in mind in its handling of the Taiwan issue.
The cautioning had the desired result because Trump in turn had reportedly conveyed to Taiwan that the latter’s concerns on the matter of independence had to be handled discreetly. He had told Taiwan plainly not to declare ‘independence.’
Accordingly, neither the US nor China had said or done anything that would have made either party lose face during their interaction. Apparently, both sides were sensitive to each others’ larger or national interests. And the economic interests of both powers were foremost among the latter considerations.
There is no glossing over or ignoring economic interests in the furtherance of ties between states. They are primal shaping forces of foreign policies and the fact that ‘economics drives politics’ is most apparent in US-China ties. That is, economic survival is fundamental.
Among the more memorable quotes from President Xi during the interaction, which also included US business leaders, was the following: ‘China’s doors will be open wider’ and US firms would have ‘broader prospects in the Chinese market.’
Xi went on to say that the sides had agreed to a ‘new positioning for ties’ based on ‘constructive strategic stability’. The implication here is that both sides would do well not to undermine existing, mutually beneficial economic relations in view of the wider national interests of both powers that are served by a continuation of these economic ties. That is, the way forward, in the words of the Chinese authorities, is ‘win-win cooperation.’
It is the above pronouncements by the Chinese authorities that probably led President Trump to gush that the talks were ‘very successful’ and of ‘historic and landmark’ importance. Such sentiments should only be expected of a billionaire US President, bent on economic empire-building.
One of the most important deals that were put through reportedly during the interaction was a Chinese agreement to buy some 200 Boeing jets and a ‘potential commitment to buy an additional 750 planes.’ However, details were not forthcoming on other business deals that may have been hatched.
Accordingly, from the viewpoint of the protagonists the talks went off well and the chances are that the sides would stand to gain substantially from unruffled future economic ties. However, there was no mention of whether the health of the world economy or the ongoing conflicts in West Asia were taken up for discussion.
Such neglect is regretful. Although the veritable economic power houses of the world, the US and China, are likely to thrive in the short and medium terms and their ruling strata could be expected to benefit enormously from these ongoing economic interactions the same could not be said of most of the rest of the world and its populations.
Needless to say, the ongoing oil and gas crisis, for instance, resulting from the conflict situation in West Asia, is taking a heavy toll on the majority of the world’s economies and the relevant publics. While no urgent intervention to ease the lot of the latter could be expected from the Trump administration there is much that China could do on this score.
China could use its good offices with the US to address the negative fallout on the poorer sections of the world from the present global economic crunch and urge the West to help in introducing systemic changes that could facilitate these positive outcomes. After all, China remains a socialist power.
Features
The Quiet Shift: China as America’s “+1” in a Changing World Order
“Everything ever said to me by any Chinese of any station during any visit was part of an intricate design”
— Henry Kissinger
That design may already be complete before this week’s , a meeting that could shape the future balance of global power.
The wind arrives quietly. By the time it is heard, history has already begun to turn. Across Asia, that wind is no longer distant. It carries with it the exhaustion of an old order and the uncertain birth of another. The question now is not whether the world will change. It is whether those who hold power possess the wisdom to guide that change toward something less violent than the century behind us.
Since 1945, the United States has carried the burden of a global order built with its Western allies. To its credit, the world avoided another direct world war between great powers. The conflicts remained contained in distant lands—proxy wars fought in the shadows of ideology, oil, and influence. From Latin America to Asia, the American century expanded not only through prosperity, but through intervention. Yet empires, even democratic ones, grow tired. Fatigue settles slowly into institutions, alliances, and public memory. The role of global policeman no longer inspires certainty in Washington as it once did.
The “rules-based order” now confronts its own contradiction: it was built to be universal, yet it often appeared selective. During my recent visit to , a young researcher asked me quietly, “Does the West itself still believe in the rules-based order?” The question lingered long after the conversation ended. The rising century demands a more inclusive architecture—one that recognises the reality of Asian power, especially China.
My three years of field research across South and Southeast Asia, documented in , revealed a transformation too significant to dismiss as temporary. China has moved beyond being merely a competitor to the United States. In trade, infrastructure, technology, cultural diplomacy, and economic influence, Beijing has established itself as what may be called the world’s “US +1.”
Great powers often search for such a partner. History shows this tendency clearly. When an empire becomes overextended—burdened by wars, alliances, sanctions, tariffs, and crises—it seeks another center of gravity to stabilize the system it can no longer manage alone. The United States today faces disorder stretching from Venezuela to Iran, from Ukraine to the unsettled Middle East. In this landscape, China emerges not simply as a rival, but as a state powerful enough to broker peace where Washington alone no longer can.
Drawing from the lessons of the Nixon–Mao era, warned that “” The United States and China are now engaged in a long-term economic, technological, political, and strategic competition. Managing that competition wisely may become the defining challenge of this century. In such a deeply polarized and unstable world, recognising China as a “US +1” partner is not surrender, but strategic realism.
Donald Trump understood this reality before boarding his flight to meet Xi Jinping. Their meeting inside Zhongnanhai—the guarded compound where China’s leadership governs—was never merely ceremonial. It symbolized a deeper recognition already acknowledged quietly within the itself: China is the nearest peer competitor the United States has ever confronted. Before departing Washington, Trump seemed to reassess not only China’s strength, but its unavoidable position as a “” shaping the future global balance.
Yet the significance of a Trump–Xi meeting extends beyond trade wars, tariffs, or diplomatic spectacle. It presents an opportunity to confront two crises shaping the century ahead: global energy insecurity and regional instability. Washington increasingly understands the limits of direct engagement with Tehran. Decades of pressure, sanctions, and confrontation have produced exhaustion rather than resolution. In that vacuum, Beijing now possesses leverage that Washington does not.
For China, this is an opportunity to evolve from a development partner into a security actor. Xi Jinping’s (GSI) was never designed merely as rhetoric. It was intended as the next phase of Chinese influence—transforming economic dependence into strategic trust. The geopolitical spillover from the Iranian conflict now offers Beijing a historic opening to project itself as a stabilising force in the region, not against the United States, but alongside it as a “US +1” partner.
If China succeeds in helping stabilise the Gulf and secure energy corridors vital to Asia, it will reshape perceptions of Chinese power globally. Beijing would no longer be seen only as the builder of ports, railways, and industrial zones, but as a guarantor of regional balance. This transition—from infrastructure diplomacy to security diplomacy—may become one of the defining geopolitical shifts of the coming decade.
Xi Jinping does not seek open confrontation. His strategy is older, more patient, and perhaps more formidable because of its restraint. Beijing speaks not of domination, but of a “,” advanced through three instruments of influence: the Global Development Initiative (GDI), the Global Security Initiative (GSI), and the Global Civilization Initiative (GCI). These are not slogans alone. Across Asia, many governments increasingly trust China as a development partner more than any other power.
India, despite its ambitions, has not matched this scale of regional penetration. In both ASEAN and South Asia, China’s economic gravity is felt more deeply. Ports, railways, technology networks, and financial dependency have altered the geopolitical map quietly, without the spectacle of war.
In , I compared three inward-looking national strategies shaping Asia today: Trump’s MAGA, Modi’s emerging economic nationalism , and Xi’s strategy. Among them, China has demonstrated the greatest structural resilience. Faced with American tariffs and decoupling pressures, Beijing diversified its supply chains across Central Asia, Europe, and Southeast Asia. Rail corridors now connect Chinese industry to European markets through Eurasia. ASEAN has surpassed the United States as China’s largest trading partner, while the European Union follows closely behind. Exports to America have declined sharply, yet China continues to expand. Trump, once defined by confrontation, now arrives seeking a new “” with China—an acknowledgment that economic rivalry alone can no longer define the relationship between the world’s two largest powers.
Unlike Washington, which increasingly retreats from multilateral institutions, Beijing presents itself as the defender of multilateralism. Whether genuine or strategic matters less than perception. In geopolitics, perception often becomes reality.
What emerges, then, is not surrender between rivals, but interdependence between powers too large to isolate one another. The future may not belong to a bipolar Cold War, but to a reluctant coexistence. The United States now recognises that China possesses diversified markets and partnerships capable of reducing dependence on America. China, in turn, understands that its long march toward global primacy still requires strategic engagement with the United States.
This is where the true geopolitical shift begins.
Many analysts continue to frame China solely as a threat. Yet history rarely moves through absolutes. The next world order may not be built through confrontation alone, but through uneasy partnership. Artificial intelligence, technological supremacy, economic stability, and global governance now demand cooperation between Washington and Beijing, whether either side admits it publicly or not.
Trump will likely celebrate his personal relationship with Xi, presenting himself as the American leader capable of negotiating a “better deal” with China than his predecessors. But beneath the rhetoric lies something larger: the gradual acceptance of China’s indispensable role in shaping the future international order.
Even the question of war increasingly returns to Beijing. If Washington seeks an understanding with Tehran, China’s influence becomes unavoidable. Iran listens to Beijing in ways it no longer listens to the West. This alone signals how profoundly the balance of power has shifted. And Xi, careful as always, refuses to openly inherit the mantle of global leadership. He delays, softens, and obscures intention. It is part of a longer strategy: to rise without provoking the final resistance of a declining hegemon too early.
History rarely announces its turning point. Empires fade slowly, while new powers rise quietly beneath the noise of the old order. Washington still holds immense power, but Beijing increasingly holds the patience, reach, and strategic depth to shape what comes after.
The century ahead may not belong to one power alone, but to the uneasy balance between Washington and Beijing. And in that silence, a new world order is already taking shape.
By Asanga Abeyagoonasekera
Features
Egypt … here I come
Chit-Chat Nethali Withanage
Three months ago, 19-year-old Nethali Withanage, with Brian Kerkoven as her mentor, walked the ramp at Colombo Fashion Week. On 06 June, she’ll walk for Sri Lanka in Hurghada, Egypt, as the country’s delegate to Top Model of the World 2026._
I caught up with Nethali as she prepares to fly out, this weekend, and here’s how our chit-chat went:
1. Tell me something about yourself?
I’m someone who blends creativity with ambition. I’ve always loved expressing myself, whether it’s through fashion, styling, or the way I present myself to the world. At the same time, I’m very driven and disciplined, especially when I was working, as a student counsellor, at Campus One, at a young age, where I’ve learned how to connect with people, understand them, and communicate with confidence. I believe I’m still evolving, and that’s what excites me the most … becoming better every single day.
2. What made you decide to be a model?
Modelling felt natural to me because it combines everything I love – fashion, confidence, and storytelling without words. I realised that modelling isn’t just about appearance, it’s about presence and how you carry your energy. I wanted to be part of an industry where I could express different sides of myself, while inspiring others to feel confident in their own skin.
3. What sets you apart from other models?
I would say my ability to connect. Whether it’s with the camera, a brand, or an audience, I bring authenticity. I also have a strong background in communication and sales, which gives me an edge in understanding how to represent a brand, not just wear it. I don’t want to just model clothes, I want to bring them to life.
4. What clothing do you prefer to model?
I enjoy modelling versatile styles, but I’m especially drawn to elegant and expressive fashion pieces that tells a story. I love looks that allow me to embody confidence and femininity, whether it’s a structured outfit or something soft and flowing.
5. What is the most important aspect of modelling?
Confidence combined with professionalism. Confidence allows you to own the moment, but professionalism ensures that you respect the work, the team, and the brand you represent. Both are equally important.
6. If you could change one thing about yourself, what would it be?
I would say I’m learning to trust myself more and not overthink. I’ve realised that growth comes from embracing who you are, not constantly trying to change it. So instead of changing something, I’m focused on becoming more confident in my own voice.
7. School?
I did my O/Ls at Seventh Day Adventist High School Kandana, and, while at school, I was actively involved in creative activities. I enjoyed participating in English Day events that allowed me to express myself and interact with others. Those experiences helped me build confidence, teamwork, and communication skills, which continue to shape who I am today.
8. Happiest moment?
One of my happiest moments is realising how far I’ve come from being unsure of myself to stepping into opportunities, like modelling, and representing myself with confidence. That feeling of growth is something I truly value, and also a dream come true!
9. Your idea of perfect happiness?
Perfect happiness for me is peace of mind, being surrounded by people I love, doing what I’m passionate about, and feeling proud of who I am becoming.
10. Your ideal guy?
My ideal partner is someone who is respectful, supportive, and confident in himself. Someone who values growth, understands my ambitions, and encourages me to be the best version of myself.
11. Which living person do you most admire?
I admire strong, self-made individuals who have built their identity through hard work and resilience. People who stay true to themselves, despite challenges, inspire me, because they show that success is not just about talent, but also about strength and consistency.
12. Your most treasured possession?
My most treasured possession is my confidence. It’s something I’ve built over time, and it allows me to face challenges, take opportunities, and believe in myself, even when things are uncertain.
13. If you were marooned on a desert island, who would you like as your companion?
I would choose someone who is calm, positive, and resourceful, someone who can turn a difficult situation into an adventure. The right mindset matters more than anything.
14. Your most embarrassing moment?
I’m 19 and still haven’t faced any most embarrassing moment. But I would say I’ve had small moments where things didn’t go as planned, but I’ve learned to laugh at myself. Those moments remind me that perfection isn’t necessary; confidence is about how you recover, not how you avoid mistakes.
15. Done anything daring?
Pursuing modelling and stepping into competitions is something I consider daring. It pushed me out of my comfort zone and challenged me to grow, both personally and professionally.
16. Your ideal vacation?
My ideal vacation would be somewhere peaceful, yet beautiful, like a beach destination where I can relax, reflect, and reconnect with myself, while enjoying nature.
17. What kind of music are you into?
I choose music that matches my mood at that time, whether it’s calm and relaxing or energetic and uplifting. Music is something that helps me express emotions and stay inspired.
18. Favourite radio station?
Usually I don’t listen to radio stations but whenever I get into a car I would search for Yes FM because it has a refined balance of contemporary hits and timeless music. I appreciate how it maintains a vibrant yet sophisticated energy, keeping listeners engaged while creating a consistently uplifting atmosphere. It’s something I enjoy because it adds a sense of positivity and elegance to my day.
19. Favourite TV station?
At the moment, I don’t have a television at home, but growing up, my favourite TV station was ‘Nickelodeon’. I genuinely loved the shows and series it aired; they were fun, creative, and full of personality. It was something I always looked forward to, and those memories still bring a sense of joy and nostalgia, whenever I think about it.
20. Any major plans for the future?
My future plans are to grow in the modelling industry, work with international brands, build a strong personal brand and finish completing a Bachelor’s Degree in Business Studies. At the same time, I want to explore my creative side further, especially in fashion and business, so I can create something of my own one day.
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