What strategies and management skills one need to learn to deal with contagious diseases in a global setting of interdependence, where issues of complexity, uncertainty, and cognition are particularly salient? What was the readiness level of public healthcare during reforms and opening-up when SARS (severe acute respiratory syndromes) hit China in 2002? How did China manage the crisis under conditions of uncertainties and unknowns? Since then what lessons has China learnt to improve both the hardware and software of its public health system? This story provides glimpses into the complex and evolving nexus of China’s healthcare system during an era of market-oriented reforms and opening-up, with a focus on public health emergencies, where “externalities” can be “fatal”.