China Coronavirus Update: China is being criticized for the delay of warning the public about the coronavirus that started in Wuhan. President Xi Jinping formally announced the public health crisis on the seventh day, January 20, 2020.
By that time, over 3,000 people had already been infected, according to internal documents obtained by The Associated Press and expert estimates on retrospective infection data.
Throughout the six days of silence, the city of Wuhan had already hosted a mass banquet for tens of thousands of people while millions started traveling through for Lunar New Year celebrations.
That delay from January 14 to January 20 had led to severe consequences. The announcement of China arrived at a critical time, the start of the coronavirus outbreak.
The coronavirus has infected almost two million people and killed more than 126,000 lives around the world.
“This is tremendous,” said Zuo-Feng Zhang, an epidemiologist at the University of California, Los Angeles.
“If they took action six days earlier, there would have been much fewer patients and medical facilities would have been sufficient. We might have avoided the collapse of Wuhan’s medical system.”
Some experts claimed that the Chinese government may have waited on warning the public to avoid hysteria and acted in private during that time.
From January 5 to 17, 2020, hundreds of patients were flocking hospitals not just in Wuhan but across the country.
No report can ascertain whether it was local officials who did not report cases or national officials who failed to document them.
However, according to experts, it is clear that China’s tight control over the narrative, from information to bureaucratic hurdles, and a hesitation to inform the chain of command shrouded early warnings.
The punishment received by eight doctors for “rumor-mongering,” shown on national television on January 2, scared the city’s hospitals.
“Doctors in Wuhan were afraid,” said Dali Yang, a professor of Chinese politics at the University of Chicago. “It was truly intimidation of an entire profession.”
Only after the first case of the infection outside China, in Thailand on January 13, did leaders in Beijing acknowledged the possible pandemic before them.
It was only then that they implemented a nationwide efforts to detect cases, such as giving away CDC-sanctioned test kits, alleviating the criteria for confirming cases, and asking health officials to screen patients, all without disseminating information to the public.
The Chinese government denied concealing details in the early days, saying it informed the World Health Organization (WHO) about the outbreak right away.
“Allegations of a cover-up or lack of transparency in China are groundless,” said foreign ministry spokesman Zhao Lijian at a Thursday press conference.
However, new evidence suggests that the head of China’s National Health Commission, Ma Xiaowei, presented a devastating assessment of the situation on January 14 in a restricted teleconference with provincial health officials.
A memo reveals that the teleconference discussed the instructions on handling the coronavirus from President Xi Jinping, Premier Li Keqiang and Vice Premier Sun Chunlan, but does not clearly indicate the instructions.
“The epidemic situation is still severe and complex, the most severe challenge since SARS in 2003, and is likely to develop into a major public health event,” the memo quotes Ma as saying.
In a faxed statement, the National Health Commission disclosed that the teleconference was held because of the case reported in Thailand and the potential spread of the virus during New Year travel.
The statement mentioned that China had published information on the outbreak in an “open, transparent, responsible and timely manner,” in accordance with “important instructions” released by President Xi.
Under a section titled “sober understanding of the situation,” the memo claimed that “clustered cases suggest that human-to-human transmission is possible.”
The document singled out the case in Thailand, adding that the situation had “changed significantly” due to the likelihood of the virus spreading abroad.
“With the coming of the Spring Festival, many people will be traveling, and the risk of transmission and spread is high,” the memo continued. “All localities must prepare for and respond to a pandemic.”
Ma told officials to unite around Xi in the memo. He pointed out that political considerations and social stability were key priorities in the upcoming political meetings that China will supposedly join in March.
“The imperatives for social stability, for not rocking the boat before these important Party congresses is pretty strong,” says Daniel Mattingly, a scholar of Chinese politics at Yale. “My guess is, they wanted to let it play out a little more and see what happened.”
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The Center for Disease Control and Prevention in Beijing launched the highest-level emergency response internally, level one, on January 15.
Their initial tasks included collecting funds, training health workers, gathering data, performing field investigations, and supervising laboratories, according to an internal CDC notice.
Meanwhile, the National Health Commission issued a 63-page set of instructions to provincial health officials. Based on the instructions, health officials must be able to detect suspected cases, hospitals to run fever clinics, and doctors and nurses to wear protective gear.
The instructions were marked “internal” — “not to be spread on the internet,” “not to be publicly disclosed.”
“We have reached the latest understanding that the risk of sustained human-to-human transmission is low,” Li Qun, the head of the China CDC’s emergency center, told Chinese state television on January 15.
On January 20, President Xi issued his first public comments on the virus, saying the outbreak “must be taken seriously” and every possible measure pursued.
If health officials informed the public about the virus prematurely, it can damage their credibility “like crying wolf” and affect how they mobilize the public, said Benjamin Cowley, an epidemiologist at the University of Hong Kong.
The delay can justify the accusations by US President Donald Trump that the Chinese government’s secrecy affected the world’s response to the virus.
Under Xi increasing political repression did not encourage officials to report cases without a clear approval from the top.
“It really increased the stakes for officials, which made them reluctant to step out of line,” said Mattingly, the Yale professor. “It made it harder for people at the local level to report bad information.”
Doctors and nurses in Wuhan told Chinese media there were indications proving the transmission of coronavirus between people as early as late December.
Wuhan’s then-mayor, Zhou Xianwang, put the blame on national regulations for the secrecy.
“As a local government official, I could disclose information only after being authorized,” Zhou told state media in late January. “A lot of people didn’t understand this.”
“The CDC acted sluggishly, assuming all was fine,” said a state health expert, who requested anonymity. “If we started to do something a week or two earlier, things could have been so much different."
