Pandemic Research Follows Initial Response Into Political Headwinds

One year ago, on 30 December 2019, Dr. Li Wenliang shared information about a patient exhibiting SARS-like symptoms with his colleagues over WeChat—the first public warning about the disease that would soon sweep the world. Within a week, George Fu Gao, the director of the Chinese Center for Disease Control and Prevention, admitted to American CDC director Robert Redfield that COVID-19 was transmissible between humans. Yet Chinese officials did not take action until January 23, when they ordered what would become the 76 day Wuhan lockdown. At The , Chris Buckley, David D. Kirkpatrick, Amy Qin and Javier C. Hernández reconstructed the the 25 days between Dr. Li Wenliang’s WeChat message and the start of the Wuhan lockdown, showing how doctors were handcuffed by political pressure which delayed China’s pandemic response:

To a degree, [Dr. Zhong Nanshan’s January 18 trip] to Wuhan was less medical than political. He already knew the virus was spreading between people; his real purpose was to break the logjam in China’s opaque system of government.

“There is certainly human-to-human transmission,” Dr. Zhong wrote in a report that he drafted on the train before reaching Wuhan, according to a recent Chinese book written with his cooperation.

[…] Doctors in Wuhan knew that, politically, there was little incentive to own up to the problem. In the Communist pecking order, the secretary of Hubei Province — whose officials had promoted a reassuring line about the virus — overshadowed the National Health Commission director.

“So what if we knew? I’d also heard of medical workers being infected,” Yu Changping, a respiratory and critical illness doctor at Renmin Hospital in Wuhan, told a Chinese newspaper about the first weeks of January. “But the discipline rules from the authorities were clear at the time, so what could I say?” [Source]

The exact number of people ultimately infected in Wuhan largely remains a mystery. A Chinese Center for Disease serological study found that 4.43% of Wuhan residents had developed antibodies to the coronavirus, which would corresponded to 487,00 infected patients, far above the official tally of 50,354 cases. A study published in June found that 3.2-3.8% of people in Wuhan had developed antibodies for the virus. Experts counseled against reading too deeply into the study. “I don’t think this means that the authorities were hiding cases,” Tao Lina, a former immunologist at the Shanghai Center for Disease Control and Prevention, told The New York Times. Instead, she and other experts posited that asymptomatic carriers and people who were only mildly ill stayed home rather than get tested, leading to the discrepancy.

One question that remains unanswered is where the coronavirus came from. Beijing has resisted a World Health Organization-led investigation into the origins of the COVID-19. Some Chinese officials have embraced unfounded theories that the virus first appeared abroad—perhaps in Italy, in one epidemiologist’s telling, or on a U.S. Army Base, in a Foreign Ministry spokesperson’s. In April, when the Australian government called for an open and transparent investigation into the origin of the virus, China initiated a retaliatory trade war. An investigation by The Associated Press’ Dake Kang, Maria Cheng, and Sam McNeil revealed that Xi Jinping personally intervened in coronavirus research, ordering scientists to submit their work for political review before publication:

A notice from a China CDC lab on Feb. 24 put in new approval processes for publication under “important instructions” from Chinese President Xi Jinping. Other notices ordered CDC staff not to share any data, specimens or other information related to the coronavirus with outside institutions or individuals.

[…] After the secret orders, the tide of research papers slowed to a trickle. Although China CDC researcher Liu Jun returned to the nearly 20 times to collect some 2,000 samples over the following months, nothing was released about what they revealed.

[…] Chinese scientists quickly started testing potential animal hosts. Records show that Xia Xueshan, an infectious diseases expert, received a 1.4 million RMB ($214,000) grant to screen animals in Yunnan for COVID-19. State media reported in February that his team collected hundreds of samples from bats, snakes, bamboo rats and other animals, and ran a picture of masked scientists in white lab coats huddled around a large, caged porcupine.

Then the government restrictions kicked in. Data on the samples still has not been made public, and Xia did not respond to requests for an interview. Although Xia has co-authored more than a dozen papers this year, an AP review shows, only two were on COVID-19, and neither focused on its origins. [Source]

Vaccine research, on the other hand, continues unhindered. Despite vaccine makers’ recent corruption scandals, China has pushed a full-speed vaccination campaign. Sinopharm, China’s state-owned pharmaceutical company, announced that its Phase 3 clinical trials showed the vaccine to be 79% effective, comfortably above the 50% threshold for medical efficacy generally adhered to by scientists. Sinopharm’s announcement contained much fewer data than comparable releases by Pfizer-BioNTech and Moderna. Michael Baker, a public health adviser to New Zealand’s government, told The New York Times, “It’s pretty light on the details[…] One question is: What markets do they propose to use these vaccines in? Because if they want to have a global market, they’re obviously going to have to supply all those details.” Despite such opacity, China plans to vaccinate 50 million of its own citizens before the February 12 start of Lunar New Year, China’s largest holiday. At The Times, Sui-Lee Wee reported on the nationwide vaccination campaign:

The campaign will focus on what China calls “key priority groups,” including doctors, hotel employees, border inspection personnel, food storage and workers, as well as travelers. Irene Zhang, a 24-year-old student, got a vaccine on Dec. 22 in the city of Hangzhou ahead of going to Britain next month for graduate school.

[…] In southern Guangdong Province, 180,000 people — mostly workers involved in food storage and transportation, quarantine facilities and border inspection — had been inoculated as of Dec. 22. In the eastern province of Zhejiang, 281,800 people had been vaccinated. In Wuhan, where the coronavirus was first detected, the government said it had designated 48 vaccination clinics for its emergency program, which started on Thursday.

[…] The government has stressed that the vaccination drive is voluntary, and people will have to pay for the inoculations. Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations and an expert on health care in China, noted that the two-dose regimen could cost about $70, putting it out of reach for the rural poor. [Source]

Although strict lockdown measures have largely crushed China’s domestic epidemic, there have still been sporadic outbreaks, most recently in Beijing and Sichuan. Some municipal authorities have encouraged, and even mandated, that people stay home for the coming Lunar New Year, rather than risk seeding a new outbreak by visiting friends and family. From Lily Kuo for The Washington Post:

This time, residents may still be restricted from celebrating. The northwestern city of Lanzhou called on families to visit relatives, a new year , online rather than in person. Several cities restricted the size of gatherings to 10 people, while in Anhui province, any company gathering of more than 50 guests must be registered with the government.

In the northeastern port city of Dalian, where authorities have been scrambling to control an outbreak, government and state company workers must apply for permission to attend any events with guests from other Chinese provinces or other countries.

[…] Beijing residents have been encouraged to celebrate the holiday in the capital, while party officials have been ordered not to leave, unless given permission. Fairs, sports events and travel groups have been suspended. [Source]

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