We've spent some time in China, and even in large cities like Guangzhou, the sanitation facilities are very poor.
Only toilet we ever saw was in our hotel room. Restaurants had restrooms but no toilets, parks and public areas had ceramic lined trenches. Many people seemed to be "expectorating" (to put it politely) on the sidewalk, even on restaurant floors.
Markets were crowded, we're talking a replay of the "Gideon" episode on Star Trek (if you're a trekkie.) And there was all kinds of animals being slaughtered and the waste from the slaughter was just pooled in the road, so you would have to walk through it.
On the other hand, Toronto seems to have been effected, so my theory may be full of holes.