COVID-19: If China is more transparent

China has been accused of covering up information, silencing doctors and failing to warn the public in the early days of the outbreak.  Questions have also been raised about whether the spread of the disease could have been stopped more effectively if the authority had been more open.  By Lee Kok Leong, executive editor, Maritime Fairtrade

On 30 Dec 2019, Dr Li Wenliang, an ophthalmologist at Wuhan Central Hospital, was one of the first people to recognize and warned about the outbreak of 2019 novel coronavirus disease (COVID-19) in Wuhan.  However, in an ironic and cruel twist, he was summoned to a police station, reprimanded for “spreading rumors online”, and forced to sign a statement acknowledging his “misdemeanor” before he was allowed to leave.  Later, he contracted the illness himself and died on 7 Feb.  

What if Chinese officials were more transparent?

Even in Dr Li’s death, there was a lack of transparency displayed by the Chinese authority.  According to the BBC, the Chinese government initially directed state-controlled news outlets to say that he was still on life support and in critical condition. These news outlets later acknowledged Dr Li’s passing, but his time of death was changed from the evening of 6 Feb, to the early hours of 7 Feb.

In the days before his death in an interview with the New York Times, Dr Li said, “If the officials had disclosed information about the epidemic earlier, I think it would have been a lot better.  There should be more openness and transparency.”

Dr Li was one of eight people who were detained for “spreading rumors” about the deadly disease’s outbreak.  The other seven, also believed to be medical professionals, were also punished.

In another sign of a lack of transparency, Chen Qiushi, a lawyer-turned-citizen journalist who had been posting critical videos of the outbreak response from Wuhan, has been forcibly quarantined, according to his friends and family.  He had been posting videos since 24 Jan, the day after the city was locked down.  His forced removal and quarantine came less than 24 hours after the death of Dr Li.

Wuhan doctors said colleagues died in vain amid official cover-up, according to a report by Caixin Global, one of China’s most influential financial media.  A Wuhan Central Hospital department head blamed authorities for endangering lives by spreading false information.

“The false information released by the relevant departments claiming the disease was controllable and would not spread from human-to-human, left hundreds of doctors and nurses in the dark, doing all they could to treat patients without knowing about the epidemic,” the department head told Caixin.  “And even when they fell ill, they could not report it. They could not alert their colleagues and the public in time despite their sacrifice. This is the most painful loss and lesson.”

In a series of interviews with Caixin, doctors at the hospital discussed a handful of key factors behind their plight.  The hospital’s Communist Party chief did not sufficiently understand infectious disease and even banned doctors from spreading critical public health information, the doctors said.  Also, an internal document obtained by Caixin revealed that interference from Wuhan’s municipal health authority made it difficult for the hospital to report cases.

What if Chinese officials’ response began earlier?

Yanzhong Huang, a China expert and senior fellow for global health at the Council on Foreign Relations, in an interview with Vox in response to a question on why the Chinese authority might delay reporting the outbreak, said that officials are only concerned about being accountable to their immediate superiors and not to the people who are affected by their decisions.  

“You have that incentive not to tell the truth, to make yourself look good. The concern about the effect on the Chinese economy and tourism, political and social stability — that was a very, very important concern.”  Huang also said another reason was that the officials did not want the outbreak to ruin the atmosphere of two important political meetings, the city People’s Congress meeting and the political consultative conference, that was held between 5 to 11 Jan. 

Huang mentioned a 29 Jan report in the New England Journal of Medicine, by authors from the Chinese CDC, that reported there were already seven health care workers infected in early January, evidence of human-to-human transmission. But the public was not kept informed about this situation until 18 Jan. People were still told there was no strong evidence of human-to-human transmission. In the same report, there was other evidence that human-to-human transmission was occurring in Dec 2019 already.

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