On December 31, 2019, the World Health Organisation’s (WHO) China office heard the first reports of a previously unknown virus, behind a number of pneumonia cases in Wuhan, a city in Eastern China with a population of over 11 million.

The fist report from WHO the World Health Organisation based in Geneva, published its first report in January 21st. At this point of time they reported a total of confirmed cases of 282, of which 278 in China, 2 in Thailand and 1 each in Japan and Korea. At about that time the first videos of a collapsed body surrounded by terrified passers-by started circulating in the social media.

On 23 January 2020, the Central Chinese government responded to the initial outbreak by placing Wuhan and nearby cities under a de-facto quarantine encompassing roughly 50 million people in Hubei province

How did it start and how did it initially propagate until the province was muzzled? Can we piece the data in a credible manner?

According to the South China Morning Post  that had a chance to see Chinese government data, , a 55 year old woman working in the meat market in Wuhan could have been the first person to have contracted on November 17, Covid-19, the disease caused by the novel coronavirus. From that date onwards, one to five new cases were reported each day.

Dr Ai Fen, the first known whistle-blower, told People magazine in an interview that was later censored, that tests showed that a patient at Wuhan Central Hospital was diagnosed on December 16 as having contracted an unknown coronavirus. By December 15, the total number of infections stood at 27 – the first double-digit daily rise was reported on December 17 – and by December 20, the total number of confirmed cases had reached 60.

Accounts by other doctors seem to suggest the medical community in Wuhan became aware of the disease in late December. Previous reports said that although doctors in the city collected samples from suspected cases in late December, they could not confirm their findings because they were bogged down by bureaucracy, such as having to get approval from the Chinese Centre for Disease Control and Prevention, which could take days. They were also ordered not to disclose any information about the new disease to the public. Dr. Li Wenliang, a 34-year-old ophthalmologist, shared on WeChat, a social media, his worries with some of his medical colleagues. He was reprimanded by the local authorities. He would later be contaminated and died at the beginning of February.

On December 27, Zhang Jixian, 54-year-old head of the respiratory department at the Hospital of Integrated Chinese and Western Medicine, using official channels told China’s health authorities that the disease was caused by a new coronavirus. By that date, more than 180 people were estimated to have been infected. By the final day of 2019, the number of confirmed cases had risen to 266, On the first day of 2020 it stood at 381. How much can we rely on a journalistic investigation when we do not know whether these were official data.

The first situation report from WHO on the 21st January reported that on the 20th of January there were 278 cases in China of which 258 from Hubei province and 20 in other provinces, which meant that the genie was already out of the Wuhan bag. Without explanation the Chinese authorities advised WHO to add to their Situation reports   131 and 384 additional unspecified cases not related to a specific province in their 3rd and 5th situation report. Are these related to the findings of the South China Morning Post?

Thereafter, until the 1st February report, the figures released by the Chinese authorities consist in a single figure all China, including Hong Kong, Macau and Taiwan! Thereafter province figures are released on a daily basis. Just as the epidemic appeared to be plateauing, on the 15th of February an additional 16,522 cases with the label “clinically diagnosed” are added on a base of 48,458 of laboratory confirmed cases. This was probably a case off putting one’s house in order, rather than a deception. Thereafter, the figures are apportioned into provinces and the plateauing trend is quickly followed by a fall in the curve. Having nothing better, we must base ourselves on the WHO information. The UN organisation does not track the disease itself but relies on nations to provide such information

According to the World Health Organisation’s website, the first confirmed Covid-19 case in China was on December 8. It is easy to rewrite history after the facts and one must recognize that, faced with a series of violent pneumonia attacks, it is impossible for one to instantly attribute it to a new virus. Moreover, in an authoritarian regime, as China, where authority is delegated in very narrow constraints, where law and order and the perception of the benevolent protective policies of the State are paramount, any rumor that could lead to disorder has to be quenched. This is what is one off the pitfalls of the authoritarian model. On the other hand, once the Central authorities recognised the problem, they responded very quickly and the fact that the epidemic outside Hubei was reasonably contained is a testimony to their effectiveness. According to figures from WHO, out of the 80,000+ cases recorded in China, about 84%, were located in the Hubei province, whereas in large cities like Beijing and Shanghai the epidemic was contained to around 400 cases in each city. Internal accounting in China indicates them at slightly over 92%

In addition to these data a very serious study: “Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia”, published recently in the New England Journal of Medicine, has an interesting graph with the early infection. We reproduce this interesting graph as it shows not only the infections, but the timeline of events. Obviously, it refers to the cases studied and the actual curve of infections in Wuhan was not a bell-shaped curve but an ascending one. It does account for a large portion of the infections reported by the South China Morning Post 

What is not in this study and has been put to our attention by our medical contacts in China, is that in Wuhan as the cases multiplied the patients were spread over the 80 different hospitals. Insufficient knowledge about the disease and of the virus behind it probably led to insufficient isolation and protection of the medical personnel and patients and led to a more rapid initial propagation of the virus. But they were acting blind and reacted with the best intent.

This epidemic is now hitting the world at large and as it progresses it has given rise, especially in countries that minimized the threat and failed to take early on preventive actions, to China bashing. Accusations fuse at the secretive attitudes of the regime and how it failed to warn other countries of the seriousness of the crisis. These are professed either by idealist ignoramuses or by media protecting their politicians.

What is evident from the chart above, is that China CDC and the local WHO office worked in tandem from New Year’s eve. By the 3rd of January, WHO in Geneva and relevant surrounding countries and provinces were advised. On the 6th of January the Chinese CDC announced the existence of a novel coronavirus and by the 10th of January China CDC was sharing with the world the gene sequence o the virus. As per the events’ timeline from the Axios blog on January 7th, President Xi became involved in the response.

Results speak for themselves. The unbridled epidemic was largely restricted to the Hubei province and largely contained in other provinces, through aggressive testing and rigid isolation of contaminated persons. These were lessons, which the West could learn from building enough infrastructure, testing kits and protective equipment, in advance of the epidemic wave that was sure to reach its territories.

By Digenis

1st April 2020

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