AP says China delayed coronavirus info and stalled sharing it with the world, frustrating the WHO
What does this really mean?
A June 2nd Associated Press news release reported that Chinese authorities delayed information on the coronavirus in the early days of the pandemic and stalled sharing that information with the world. AP’s findings were based on “new” information gleaned from secret recordings of meetings of epidemiologists and others at the WHO during the week of Jan. 6, 2020. The meetings occurred within days after Chinese researchers had identified the pathogen as a novel coronavirus that was causing a pneumonia outbreak in the city of Wuhan. The recordings apparently revealed frustrations on the part of WHO staff as they waited for genomic sequencing of the virus and an update on the disease spread among the residents of Wuhan. “We’re going on very minimal information” WHO epidemiologist Maria Van Kerkhove is reported to have said in one of the early meetings. “It’s clearly not enough for you to do proper planning.”
A week later, when China did share the full genetic sequence of the Wuhan virus (later named SARS-COV-2) on Jan. 12, and then the epidemiological data by Jan. 24 (or before), the WHO publicly lauded China for its promptness and transparency. The AP conjectured that the WHO was conciliatory in public in order to coax more information out of the Chinese government. But more likely, the WHO was genuinely pleased and relieved to get the data they needed in a reasonably timely manner.
Credibly, the WHO “always” wants to have information as early as possible, according to an April 27, 2020 TIME interview with Maria Van Kerkhove:
“There’s an international set of rules that governments have agreed upon to share this information with us. We never publicly criticize our member states, but we actively push back in discussions with them for more information, always, always, always.”
The AP release did not mention an important article published Jan. 24 in the leading British medical journal, the Lancet, describing details of the original cluster of 41 pneumonia patients and the current state of the disease outbreak on the ground in Wuhan, including the number of deaths. That article—authored by the medical team from Jin Yin-tan Hospital where the patients were under care, in collaboration with a dozen or so other research institutions in China, including 28 collaborating scientists in all— summarized the epidemic as follows:
“Thus far, more than 800 confirmed cases, including in health-care workers, have been identified in Wuhan, and several exported cases have been confirmed in other provinces in China, and in Thailand, Japan, South Korea, and the USA. ….Taken together, evidence so far indicates human transmission for 2019-nCoV… Airborne precautions, such as a fit-tested N95 respirator, and other personal protective equipment are strongly recommended.”
This release of information was exactly the epidemiological data the WHO was waiting for.
Other scientific articles of importance were also published globally throughout January including several papers with “estimates of how rapidly the virus spreads, or the length of its incubation period.” On January 22, the European Centre for Disease Prevention and Control released the following statement regarding the risk of global spread:
“Based on the genetic similarities between 2019-nCOV and SARS-CoV, the limited epidemiological information available from China and the detection of cases through entry screening outside of China, it is possible that new cases will be detected among travellers from Wuhan. Without implementation of appropriate infection prevention and control measures at the point of care for persons under investigation, there is a moderate likelihood of outbreaks in destination countries. In the past, systematic implementation of infection prevention and control measures were effective in controlling both SARS-CoV and MERS-CoV.”
A later article published on Wired.com “Inside the early days of China’s coronavirus coverup” reports an “uncharacteristic degree of openness in the flow of information out of Wuhan” during January. “Coverup” in the Wired article did not refer to scientific information produced in the first weeks of January but to extreme government censorship, even by Chinese standards, that occurred later in February and March as authorities clamped down hard on journalists, regular citizens on social media, and medical personnel. The Wired article reported widespread censorship of online material to “coverup” the chaos, suffering, and death that resulted from the pandemic as it surged out of control and overwhelmed the medical system—not something the Chinese authorities wished to publicize.
By all accounts, sequencing the SARS-COV-2 genome in early January went incredibly quickly. Even including the so-called “delay” of a week, it took less than two weeks to go from an unknown pathogen to sharing the pathogen’s genome with the world. Epidemiological data was not far behind, coming out two weeks later. In normal times, a month from identifying a disease cluster, to managing human subjects, collecting and analyzing data, and publishing in a peer-reviewed journal, not to mention coordinating results among 28 researchers, would be considered astonishingly rapid.
But these are not normal times. Two weeks, and even two days are interminable to the people at the WHO in the face of a potential pandemic. The WHO staff were likely quite relieved when China released its data in a reasonably speedy manner. It is natural with the benefit of hindsight to think of all that could have been accomplished during those early weeks before human-to-human transmission was officially announced. But would the world have responded any differently? There were countries that were poised to manage a pandemic and countries that were not.
According to Van Kerkhove, infectious disease authorities around the world would, of course, assume human-to-human transmission to go along with pneumonia clusters (until proven otherwise). What the WHO needed was confirmation of disease clusters, the mode and degree of transmissibility of the disease (R naught), and the severity of the outcomes (fatality rates), all which were unknown in early January. In the TIME interview Kerkhove affirmed that person-to-person transmission was assumed by the WHO:
“That’s what we acted on. You worry about how a respiratory virus transmits and the efficiency with which it transmits. From day one, we’ve been talking about all of the types of scenarios that transmission could look like. We warned against aerosol transmission, airborne transmission.”
Could a two-week (or less) wait for the epidemiologic data really be considered stalling, as the AP news release suggests? More likely, an additional two weeks was the amount of time that it took to collect and manage data and produce reportable results. Information delays measured in days when much was still unknown about the virus hardly compare to actionable delays of weeks and even months for much of the developed world outside of Asia to take action. Countries both inside and outside Asia had the benefit of witnessing the Wuhan epidemic, if not in excruciating detail, at least through the statistics on geometrically escalating cases and deaths—and by observing China’s strong mitigation efforts of temperature taking, mask wearing, border closings, and locking down of citizens. Yet many countries delayed mitigation efforts of their own for weeks after cases arrived on their shores…until the effects of the pandemic became obvious, that is, until deaths started to accrue.
So what was the “news” in the June 2 story put forth by the AP? The basic message of the AP story can be summarized as follows: During meetings in early January WHO staff were nervous and frustrated until the data was released. When the data was released in a reasonably timely manner, the WHO lauded the Chinese for their prompt and transparent communications to the world. The AP article makes an additional point that collusion between the WHO and China regarding an early January coverup can be reasonably and confidently ruled out. But, look for the meme “China … delayed … stalled …WHO … frustrated” to be around for a while.
