WHO boss supported by China is now giving the nation too much credit on coronavirus, critics claim
If the World Health Organisation’s verdict is to be believed, China’s behaviour in the coronavirus crisis has been exemplary.
Officials who returned from a “joint mission” to the country in February described how China had “rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history”.
WHO’s director general, Tedros Adhanom Ghebreyesus, claimed that China’s lockdown strategy had “bought time for the world”.
However, concerns are now growing that far from buying time, China has put the world on the back foot by publishing data about the spread of the disease that is at best inconsistent and at worst heavily massaged.
It has also been accused of silencing whistle-blowers, and overlooking early evidence of the infectiousness of the disease.
Chinese authorities have changed the way they count coronavirus cases no less than eight times since the outbreak began, and only this week started counting asymptomatic cases in its official statistics.
When the daily counts started in January, the China’s National Health Commission’s definition of a coronavirus case was much more restrictive than it is now.
Patients only qualified as suspected cases if they displayed all four of a list of specific symptoms - including pneumonia indicated by a chest radiograph – and had also either travelled or had indirect contact with a Wuhan market within the previous fortnight.
Inevitably, tens of thousands of milder cases of coronavirus slipped through unrecorded.
Even now that the definition has been tightened, senior politicians and US intelligence have expressed concerns that the statistics released by China may be fiction.
Certainly the statistics look out of kilter. China was affected weeks before any other nation, but has only reported around 82,500 cases so far.
By comparison, the US which had its first coronavirus case in mid-January, has reported more than 245,000 – more than three times China’s figure, according to data collated by Johns Hopkins University in America. The UK, whose population is less than five per cent of China’s – and which has lagged far behind on testing - has already reported 34,173 cases. This is 41 per cent of China’s total.
Conservative MP Iain Duncan Smith, an outspoken China critic, told the Telegraph: "There has already been a hit on the Chinese economy as a result of this, so their desperate concern is to alleviate that as quickly as possible - and my concern is that in that drive to do so, the figures for what is happening in China are being obscured.”
He added: “I really don’t believe these figures. I think they’ve suppressed it massively.”
A WHO spokesman said: “WHO’s mandate is to keep all people safe everywhere and this is what our scientists and public health experts are doing. The membership of the UN is decided by the countries. This does not affect WHO’s mandate as an evidence-based organization that safeguards the global public health.”
Allies of Dr Tedros point to the fact that, as the former health minister then foreign minister of Ethiopia, he is naturally given to diplomacy – and that praising China ensures the nation continues sharing critical information.
However, critics note that China was highly influential in him gaining the position in the first place.
According to reports, Chinese diplomats campaigned hard for him in the 2017 leadership election, using the promise of Beijing’s financial muscle to put pressure on developing countries to do the same – helping him to stave off competition from Britain’s David Nabarro.
The official toll of the number of cases is not the only point of information that has shaped the way other countries prepared for coronavirus. Chinese authorities also peddled the line that there was no clear evidence of human-to-human transmission - apparently overlooking early signs that patients were catching it from each other.
A paper published in The Lancet and co-authored by doctors who worked at Jin Yin-tan hospital in Wuhan noted that the wife of the very first patient to die of coronavirus also "presented with pneumonia and was hospitalised in the isolation ward”.
The study - Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China - stops short of saying she caught coronavirus from him, but points out that she had “no known history of exposure to the market”.
The same study also claims that just one of the four earliest known coronavirus patients had links to Huanan Seafood Market - casting doubt on the popular notion advanced in Wuhan that the disease originated in wet markets.
There, a shrimp seller named Wei Guixian, was identified by the Wall Street Journal as one of the very first patients, after she began experiencing symptoms on December 10.
However, experts now believe that the disease began to spread in China much earlier than that. A little-discussed graph in the Lancet paper claims that the first coronavirus patient started feeling the effects of the disease on 1 December – a week and a half earlier.
Meanwhile, the South China Morning Post claims to have seen confidential government documents that suggest the first confirmed coronavirus patient may have contracted the disease on 17 November. If true, knowing about it early on would have had huge ramifications.
Research by the University of Southampton suggests that 95 per cent of infections could have been avoided if China had acted three weeks earlier.
Professor Larry Gostin, director of the World Health Organization Collaborating Center on Public Health Law & Human Rights, told the Telegraph: "It delayed for three to four weeks before reporting a novel virus to the WHO which probably cost hundreds of thousands of lives globally…Its record does not deserve praise."
The first whistle-blower was Ai Fen, a senior doctor at Wuhan Central Hospital, who on 30 December posted information about the new virus on the WeChat social media platform.
Later that day, Dr Li Wenliang, an ophthalmologist at the same hospital, also posted information on WeChat about the virus he believed to be Severe Acute Respiratory Syndrome, or Sars.
He and Dr Ai were both reprimanded, and Dr Wenliang was instructed by the hospital to write a “reflection” on the spread of false information.
Within two days, the Wuhan Public Security Bureau had reportedly called another eight doctors in for questioning after they discussed the virus on social media. According to Chinese media, the Hubei Provincial Health Commission ordered laboratories that were testing samples for the new virus to stop doing so, and to destroy any existing samples they had.
John Mackenzie, a member of the World Health Organisation’s emergency committee and emeritus professor at Curtin University in Australia, told the Financial Times in February that some aspects of China’s response was “reprehensible” and that he believes they tried to “keep the figures quiet for a while”.
Mr Mackenzie’s misgivings were backed by numerous reports in Chinese media, but Dr Tedros distanced himself from Mr Mackenzie’s critical remarks.
He said that he could not comment whether or not China had hidden the start of the coronavirus outbreak but that if China did conceal the extent of the outbreak “it really defeats logic” because there would have been a higher number of cases around the world.
That was in February, when the number of non-Chinese cases was still “very small”. The global death toll is now around 54,000.
The WHO position is in contrast to the organisation’s handling of the 2003 SARS crisis when Gro Harlem Brundtland was director general.
When the WHO declared a global health alert for SARS, there were just over 150 cases worldwide. When Covid-19 was named a public health emergency of international concern, there were nearly 10,000.
Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations, and author of a paper on the SARS response, said that the WHO did not use the new range of tools that have since been put at its disposal.
“Very often the WHO seems to be downplaying the Chinese response in the early stage of the crisis…It might be diplomatically unwise to criticise [China] but I do believe the WHO could take a more balanced approach."
This is rejected by the WHO, which says that it co-ordinates the international response to Covid-19 in a “transparent way”, publishing on its website information that can help countries and individuals respond to the crisis.
“Part of WHO’s mandate is to inform all member states and we do it both through bilateral exchanges and through weekly briefings where all countries are invited. Throughout the outbreak, there have been regular and frequent meetings and discussions between WHO leadership and technical experts from around the world,” a spokesman said.
Indeed, Dr Nabarro – who fought Dr Tedros to become director general and is now a WHO envoy – suggested that his former opponent may have got the balance right. “When this started, we were able to benefit from china making the structure of the virus available in the public domain extremely quickly and we’re grateful for that and we’re grateful for information that has been received about the virus.”
“Let’s do all the post mortems of all governments when we’ve got through this. We will all be accountable and that’s how it should be.”
Professor Gostin, who was Dr Nabarro’s spokesman during the leadership race, was less charitable. “When we look back and see so much praise going towards China and its system will the message be that civil rights aren't as important as we believe them to be? I believe in telling truth to power.'