Citizen Action Monitor

China’s COVID Secrets: The untold story of the beginning of the coronavirus pandemic

Watch FRONTLINE’s 83-minute documentary here, along with the full transcript. —

No 2707 Posted by fw, February 07, 2021 —

“VICTOR SHIH: At the very beginning of January, the central government had dispatched a team of leading infectious disease experts from the Peking University School of Medicine, that’s kind of like the Harvard Medical School of China, as well as from other leading universities. And so they arrived in Wuhan. They began to look at the clinical data that they had gathered up to Jan. 2.

NARRATOR: The data covered all 41 official cases hospitalized by Jan. 2. It was an alarming picture. It turned out only two-thirds of cases were linked to the Huanan market. The first case had no link to any of the others. There were clusters of cases within families. The National Health Commission scientists concluded the virus could have acquired the ability for ‘efficient human-to-human transmission’ and that there was potential for a pandemic.”

To this date, You Tube’s website video of China’s COVID Secrets recorded 477,632 views, and 3,812 comments.

 

FRONTLINE’s video of China’s COVID Secrets tells the untold story of the beginning of the coronavirus pandemic and how China responded. Chinese scientists and doctors, international disease experts and health officials reveal missed opportunities to suppress the outbreak, and lessons for the world. This one-hour, 23-minute documentary reveals the gulf between what China knew and what it told the world. A coproduction with the BBC.

Below is an embedded video of the full documentary, along with FRONTLINE’s full transcript.

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China’s COVID Secrets (full documentary) | FRONTLINE PBS, Broadcast February 2, 2021

 

TRANSCRIPT

Transcript – China’s COVID Secrets

MALE NEWSREADER:

—case here of a severe flu-like illness which experts say is a worldwide threat to health.

MALE NEWSREADER:

The pneumonia-type bug first appeared in Guangdong Province, officials there saying the outbreak is under control.

MALE NEWSREADER:

The World Health Organization has issued a global alert.

MALE NEWSREADER:

—virus behind a severe outbreak of pneumonia.

Guangdong Province

People’s Republic of China

2002

NARRATOR:

The roots of China’s response to COVID-19 go back almost 20 years, to another deadly outbreak.

LAWRENCE GOSTIN, WHO Center on Health Law, Georgetown Univ.:

The story does start with SARS, and it began with the lack of transparency from China.

NARRATOR:

In November 2002, an outbreak of severe acute respiratory syndrome, or SARS, began in southern China. The virus is thought to have passed from a bat into a civet cat and into humans at a market. It then spread quickly through southern China’s crowded factory cities.

YANZHONG HUANG, Sr. Fellow, Council on Foreign Relations:

Doctors identified that something unusual happening, reported it to the local public health authorities. It took weeks and months for them to take a decisive action.

NARRATOR:

China’s authoritarian government maintained everything was under control.

RICHARD HORTON, The Lancet:

The immediate response of the Chinese government was literally to lie and dissemble, and that caused total confusion for the rest of the world as this epidemic began to ignite.

NARRATOR:

Five months into the outbreak, a Beijing doctor exposed what was really happening. He revealed there were many more cases than the government was letting on.

The central government in Beijing now admitted the scope of the problem.

MALE NEWSREADER:

SARS has come to North America.

MALE NEWSREADER:

A thousand people have been quarantined in Hong Kong.

FEMALE NEWSREADER:

Two dead in Canada and six cases in Europe.

NARRATOR:

By this time, SARS had spread around the world. It would ultimately cause almost 800 deaths. In China, the cover-up shook the country.

YANZHONG HUANG:

Chinese people became very concerned but also angry that the government was not telling them the truth.

Maria Repnikova, Georgia State University:

There were stories of people rising up, mistrusting information. The damage to the reputation of the party state, domestically and internationally, was very heavy. It was felt.

NARRATOR:

SARS was deadly, but its ability to spread was limited. Within eight months, the outbreak was contained.

LAWRENCE GOSTIN:

It was widely seen that the delay by China in reporting and actually responding was absolutely the reason why we weren’t able to nip it in the bud.

And so the narrative in the global health world was China did learn a lesson, they would be better next time and that they would be much more responsive and transparent.

China Center for Disease Control

Beijing

NARRATOR:

Beijing set about making sure that SARS could not happen again. The following year it began creating what it has claimed is the largest online infectious diseases reporting system in the world, run from the Center for Disease Control, China’s CDC.

IAN LIPKIN, Center for Infection and Immunity, Columbia Univ.:

I helped them develop the national CDC. The CDC that I first visited was in disrepair. That’s completely changed.

And what they did was they created these various programs—there was a hundred talents, a thousand talents—so that people who had been trained in other parts of the world were recruited back to China to contribute to the establishment of new infrastructure for infectious disease surveillance.

NARRATOR:

One of those recruits was George Gao, a virologist at Oxford University. He became the head of the China CDC in 2017.

GEORGE GAO:

Let me tell you how we organize the disease control and public health in China: surveillance. We have the general centralized data center within China CDC. I will know within hours whether or not we have a outbreak, even in a small village.

NARRATOR:

By 2019, Gao was promising that the country’s new online surveillance system would be able to prevent another outbreak like SARS.

YANZHONG HUANG:

So they were indeed confident that they had the capacity to handle well a major disease outbreak should it happen, that they would be able to nip the crisis in the bud.

Wuhan

Population: 11 Million

Day One

December 1, 2019

Officially Reported Cases: 0

NARRATOR:

On the 1st of December 2019, a man in his 70s fell ill. He was admitted to a hospital in Wuhan, a vast industrial city and the transport hub of central China.

COVID Case Estimate

Mid-November: 0

December 11: 70-200

Northeastern Univ.

NARRATOR:

Unbeknownst to anyone at the time, within days up to 200 people were likely already infected with the coronavirus. They were walking around undetected, most likely with mild symptoms or none at all. Many of the cases would be traced to a sprawling live animal market which supplied the city’s restaurants and food shops.

Huanan Seafood Market

EDWARD HOLMES, Virologist, University of Sydney:

Colleagues at the Wuhan CDC, the Wuhan Center for Disease Control, in 2014 took me there, really to say, “Look, look at this place. This is the kind of place where emerging microbes may appear.”

And I took lots of photographs because they are quite jarring. There were snakes, cats, raccoon dog, and they were sometimes in individual cages on the floor and sometimes stacked on top of each other.

NARRATOR:

After SARS, Beijing had passed a law requiring markets to maintain sanitary standards, but it was widely ignored.

PETER DASZAK, EcoHealth Alliance:

People will kill animals in front of you. There’s feces, guts, blood, organs lying around, with wild birds coming down and feeding on it. You’ve got thousands of people congregating. It’s a really good place for a virus to spread from one person to another and get out into the community.

NARRATOR:

It’s not known whether the market was where the virus first made the leap from animals to humans. But by mid-December several people were turning up at nearby hospitals. Doctors noticed a pattern: strange white spots in patients’ lung scans.

EDWARD HOLMES:

Doctors put two and two together. If you were in a hospital and you see one pneumonia patient or even two, you may not think anything untoward’s happening. But the fact that they were seeing them in different locations meant that—that cluster meant that there was an infectious agent going around.

December 24, 2019

Day 24

Officially Reported Cases: 0

NARRATOR:

Three weeks after the first illnesses emerged, doctors at Wuhan Central Hospital took a sample from a patient’s lungs. They sent it to Vision Medicals, a private company more than 500 miles away.

Within 48 hours, the company had come up with a short genetic sequence of the virus. A technician at the lab later posted an online account of what happened next.

Virologist Wang Linfa read the post before it was removed from the internet.

WANG LINFA, Duke-NUS Medical School, Singapore:

The report back on Dec. 26 is to say, “Oh, my God, this patient’s samples contain genetic sequence most related to bat coronavirus.”

NARRATOR:

The technician then privately told his boss about the coronavirus over the messaging app WeChat.

Coronaviruses are a large family of viruses which includes SARS and the common cold. The sequence from Wuhan hadn’t been seen before, but it was strikingly similar to SARS.

WANG LINFA:

The person who operated that machine and did the analysis basically sent a red light flash to the boss of the company. And the boss says, “This is serious. Don’t send a report out until you’re 100% sure.”

And a few hours later, basically says, “I’m 100% sure; this is real.”

NARRATOR:

The lab informed the doctors at the hospital and the Wuhan CDC. They also sent the sequence results to the state-run Chinese Academy of Medical Sciences in Beijing.

Over the coming days, word of a new SARS-like virus was starting to spread among officials in Wuhan and Beijing. Several more samples were sent to other labs for sequencing. None of these results were initially shared with the international community.

DAKE KANG, The Associated Press:

So the sequence of a pathogen is really important because that is what allows people to figure out how quickly the pathogen is spreading and to be able to create tests to detect the virus. It’s really crucial information for health authorities in other countries to start detecting this virus. Where is it going? Is it going to go outside of China? Is it going to become a pandemic? Is it human-to-human transmissible?

Of course, you don’t want to rush out some information that could potentially be false and make everyone think that this is some other kind of pathogen and somehow misinform people.

COVID Case Estimate

December 11, 2019: 70-200

December 30, 2019: 2,300-4,000

Northeastern Univ.

NARRATOR:

Almost a month after the first cases emerged, hospitals in Wuhan were receiving dozens of patients with severe pneumonia.

Wuhan’s 11 million people were still going about their lives as normal, unwittingly spreading the virus around the city and to the rest of China.

Then a lab in Beijing that had been reviewing a sample of the virus sent Wuhan Central Hospital some startling results. This lab had gotten a different result from the previous one: rather than a virus similar to SARS, they said it was SARS itself.

It would turn out the lab had made a mistake, but the results quickly started circulating among doctors at Wuhan Central Hospital.

MARIA REPNIKOVA:

This was the first time that the information about the possibility of this virus was shared. This was the first time there was documentation, there was evidence that something was really happening and that’s being shared publicly.

WeChat groups are like little discussion circles—could be hundreds of people in one group. And it’s very, very easy for information to spread, and it spreads like fire.

NARRATOR:

At around 5.30 p.m. it reached Li Wenliang, an eye doctor. He forwarded it on, with a warning: “Don’t circulate this information outside the group, tell your family and loved ones to take precautions.”

JAMES PALMER, Foreign Policy:

He was talking to a group of fellow doctors from his university when he brought up the problem. He wasn’t trying to go public. And in the ordinary course of events, it would have been like a little black mark on a record somewhere. Instead he ended up at this kind of crux of history.

NARRATOR:

His message went viral. In Wuhan, the local health commission ordered the city’s hospitals to report any new cases directly to them and barred them from releasing information to the public.

Within 12 minutes, the orders were leaked. They, too, were widely shared on the internet.

News of an outbreak had escaped.

New York

December 30, 2019

Day 30

Officially Reported Cases: 0

FEMALE NEWSREADER:

I guess you could say it’s the most wonderful and busiest time of year. A lot of people, high volume, are going to be traveling.

FEMALE NEWSREADER:

—they say an estimated 42 million—

NARRATOR:

That night, the rumors reached Marjorie Pollack, an epidemiologist with ProMED, an organization which sends out alerts on disease outbreaks.

MARJORIE POLLACK, Program for Monitoring Emerging Diseases:

I checked my email after dinner and I had an email from a colleague in Taiwan: social media was ripe with lots of chatter going on in Chinese of an outbreak and did we know anything about it.

I was able to monitor the Weibo posts, and it was just going wild. My reaction was “we’re in trouble.” It was very much a deja vu of what happened with SARS-1. So, put together a report to go out as what we would call an emergency post, getting it out as soon as possible.

NARRATOR:

It went out to around 80,000 subscribers worldwide.

MALE NEWSREADER:

It’s already the new year in much of the world, and here in New York they’re getting ready for the most famous New Year’s spectacle: the ball drop in Times Square.

NARRATOR:

Peter Daszak, head of a New York-based infectious disease research organization, contacted Marjorie Pollack with more news.

PETER DASZAK:

I got hold of her on New Year’s Eve, and as the champagne was getting warm we realized something really serious was going on in China. We had it from a good source that this was a coronavirus and that it was 20% different to SARS. So we knew that SARS was pretty good at transmitting from person to person; we knew it had a 10% mortality rate. That’s a huge red flag.

I really knew something was wrong when every single senior person that I was trying to get hold of in China was busy. I sent a really long text to George Gao, who’s head of the CDC. I offered to send a team out there, to come out there and do anything to support them, and I got the shortest response ever from George, which was “Happy New Year.”

NARRATOR:

But George Gao did contact virologist Ian Lipkin with information about the virus. This is the first time Lipkin has publicly recounted details of their conversation.

IAN LIPKIN:

I was in a restaurant waiting to ring in the new year, and I got a call on WeChat. And it was George Gao. He’d identified the virus, it was a new coronavirus and that it was not highly transmissible. Well, this didn’t really resonate with me because I’d heard about many, many people who’d been infected.

I think he was just wrong. I don’t think he was duplicitous, I think he was just wrong. He should have released some sequences and said, “This is what we know, these are the sequences we have.”

My view is that you get it out. That’s the way we do it because this is too important to hesitate.

CROWD [chanting]:

Ten, nine, eight, seven, six, five, four, three, two, one! [cheering]

NARRATOR:

George Gao did not respond to our interview requests. He has told Chinese state media that the sequences were released as quickly as possible and that he never told the public there was no human-to-human transmission.

JAMES PALMER:

News of the possible outbreak had actually spread far beyond Wuhan by late December. And suddenly there was this increasing kind of pressure because the outside world was looking, but that’s a dual-edged sword in China, because on the one hand, the outside world looking can create pressure to act. The outside world looking can also create pressure to cover up.

MALE NEWSREADER:

Viral pneumonia has hit central China’s Wuhan city. Authorities have reported 27 cases in total, seven of which are critical.

NARRATOR:

The National Health Commission now instructed Wuhan health officials to announce the outbreak. The news was aired on state-run TV.

MALE NEWSREADER:

Patients are reported to have worked at a local seafood market. An investigation—

NARRATOR:

But the officials played it down, describing it only as a “viral pneumonia” that was under control.

MALE VOICE:

[Speaking Chinese] We’ve investigated and it has no relationship to SARS. We are investigating other pathogens.

NARRATOR:

They reassured the public that there was no evidence of human-to-human transmission and closed the market where they maintained many cases had originated.

JAMES PALMER:

The first instinct of the authorities is always to cover up. One of the key values of the Chinese Communist Party for the last 40-odd years has been stability—the avoidance of what they see as chaos, the dangers of revolution, overthrow. But the party’s also very concerned about the idea that whole populations might freak out and that might result in mass shortages, people being crushed to death trying to flee somewhere. That urge to control, that belief that the public can’t be trusted is also very ingrained.

VICTOR SHIH, University of California, San Diego:

The definition of stability keeps getting escalated as the ability of the Chinese government to monitor absolutely everything improves. Even some of the thoughts and speeches of Chinese citizens, they are now seen as signs of instability. Increasingly, even in WeChat, which is a private platform, that kind of so-called deviant speech would be punished with administrative detention or suspension of accounts.

MALE NEWSREADER:

[Speaking Chinese] On Jan. 1, the Wuhan Municipal Public Security Bureau published information regarding the current situation with the Wuhan pneumonia outbreak.

NARRATOR:

On Jan. 1, the Wuhan police dealt with the doctors who’d spread the news of an outbreak. On state TV, they were labeled “rumormongers” and “internet users.” Several were given official reprimands by the police.

The news was widely covered on national television.

NEWSREADERS:

[Speaking Chinese, overlapping] The police will investigate and deal with all illegal acts that fabricate and spread rumors and disrupt social order. Acts like this will not be tolerated.

NARRATOR:

The eye doctor Li Wenliang, whose post had gone viral, was called to a police station, where he signed a confession.

The Chinese government has disputed that what happened to Li is evidence they were trying to suppress news of the outbreak. They say he was simply being urged not to spread unconfirmed information and that all countries have strict rules on the confirmation of infectious diseases.

But the clampdown extended beyond doctors. Chinese journalists were now subject to specific censorship instructions, and key words began to disappear from the internet.

SUI-LEE WEE, The New York Times:

When I first started seeing the reports on Dec. 31, doctors from inside were describing it as SARS.

So I started searching “Wuhan SARS” to see what the discussion was online, and I couldn’t find anything. You had that standard term “that relevant search term is blocked,” which was not a surprise, because the government obviously wants to keep things stable. I’m pretty sure they did not want any comparison to SARS; they wouldn’t want a panic to ensue because of that.

NARRATOR:

But by now in Beijing and Wuhan, top government officials were confronting evidence that they were dealing with something potentially serious: a novel coronavirus.

Geneva

LAWRENCE GOSTIN:

So let me tell you what international law requires. If the government knows about a novel infection that meets the criteria within the International Health Regulations, and a novel coronavirus by definition meets those criteria of a potential public health emergency of international concern, the government is obliged by law to report that to the World Health Organization within 24 hours.

So it was reportable. The failure to report clearly was a violation of the International Health Regulations.

NARRATOR:

The World Health Organization first learned about the outbreak not from the Chinese government, but from social media and the ProMED post.

On Jan. 1, its incident management team began a series of emergency conference calls.

MARIA VAN KERKHOVE, COVID-19 Technical Lead, WHO:

I remember sitting on the floor in the living room of my sister’s house at 3:00 in the morning on those calls with the aim of really understanding the situation. We had the assumption initially that this may be something new, that it may be a new coronavirus. And as a respiratory pathogen, for us it wasn’t a matter of if human-to-human transmission was happening, it was “what is the extent of it and where is that happening.”

NARRATOR:

WHO officials requested more information from China’s National Health Commission. It was two days before they heard back. What they were told was vague: there were “44 cases of viral pneumonia of unknown cause.”

LAWRENCE GOSTIN:

The country has an obligation to answer WHO’s questions honestly, fully and transparently, and I don’t think that that happened entirely.

Any time you get an emerging disease outbreak, it’s a little bit of chaos at the beginning, and also a little bit of disbelief. But having said that, it’s hard knowing what happened at SARS why the WHO was not informed straightaway.

2003 SARS Outbreak

LAWRENCE GOSTIN:

Once you report to WHO, it’s open to the world. You start to get travel and trade restrictions placed upon you. China had the memory that they lost a lot of economic productivity and travel and tourism and trade during SARS. And so I think China’s view was that it wanted to handle this pretty much and that it was going to. It didn’t want outside interference.

NARRATOR:

The Chinese government refused multiple interview requests. Instead, it shared a document called “Reality Check of U.S. Allegations Against China on COVID-19.” The document states: “We have all along been in good communication and cooperation with the WHO” and “China has provided timely information to the world in an open, transparent and responsible manner.”

January 3, 2020

Day 34

Officially Reported Cases: 44

NARRATOR:

The National Health Commission now had a team of scientists and officials on the ground in Wuhan, investigating the outbreak. And labs across the country were secretly racing to map the complete genetic sequence of the new virus. One of those labs was run by a renowned virologist in Shanghai, Professor Zhang Yongzhen.

EDWARD HOLMES:

Professor Zhang is a very friendly, passionate, extraordinarily hard-working scientist. I’ve been working with him since 2012, and we essentially use genomic technology to try and understand virus evolution and diversity. Just how many viruses are there? How big is the total universe of viruses, the virosphere?

NARRATOR:

Virologist Eddie Holmes and Professor Zhang were in the middle of a long-term project on respiratory diseases at Wuhan Central Hospital when the outbreak began.

On the 2nd of January, lung samples from infected Wuhan patients were sent by high-speed train to Zhang’s lab. At around 2:00 a.m. on the 5th of January, a breakthrough: Zhang had obtained the full genetic sequence of the virus.

EDWARD HOLMES:

I was driving to breakfast and he called me on the car phone. His team had worked very hard and so he was very proud, obviously, of the work they’d put in. On that very day he was working to try and get information released as soon as possible so the rest of the world could see what it was and so that we could get diagnostics going.

NARRATOR:

It was important confirmation that the virus was very similar to SARS and therefore likely transmissible between humans.

Zhang’s office immediately wrote to the National Health Commission, advising preventative measures in public places.

Zhang and Holmes wanted to make the sequence public right away—but they couldn’t.

EDWARD HOLMES:

There was an official memorandum that had gone through saying that we were not allowed to do this. So he was put in quite a difficult position.

NARRATOR:

Two days earlier, the National Health Commission had sent out secret instructions to laboratories, forbidding them from publishing their results without authorization and requiring them to destroy or hand over their samples.

The Health Commission’s orders were later leaked. Four other Chinese labs also obtained the full genetic sequence of the virus. They, too, were forced to sit on their findings.

DAKE KANG:

The notice says very clearly that you cannot spread or disseminate any information about this pathogen to the outside world. And what that effectively did was it silenced individual scientists and laboratories from talking about this outbreak, from revealing information about this virus and potentially allowing word of it to leak out to the outside world and alarm people.

The question then naturally becomes, why would you do something like that? Why would you order people not to talk about this virus? And it’s difficult to say exactly what the motives were behind that order. From all indications from the way they behaved in early January, they seemed to be really treating this a slow-moving virus.

NARRATOR:

Doctors were now dealing with more and more people turning up sick in Wuhan’s hospitals. Health workers have been forbidden from talking to the international media without authorization. But one agreed to speak.

This is the first time a health worker from Wuhan Central Hospital has talked to international journalists about what was happening in those early days of the outbreak. We are protecting the person’s identity and using an actor’s voice.

Health Worker

Wuhan Central Hospital

 

MALE VOICE:

I began to suspect there was human-to-human transmission around the 5th or 7th January. There were so many people who had a fever. The respiratory department became full around the 9th or 10th January. I realized that this thing had become big. It was out of control. Then we started to panic.

NARRATOR:

But on state television, a representative of the government team investigating the outbreak maintained it was a viral pneumonia.

WANG GUANGFA, Peking University:

[Speaking Chinese] Overall, the current situation is controllable. Most patients have a light illness and a number of them have already left the hospital. Of course, some cases are serious. Every year we have cases of serious pneumonia.

Health Worker

Wuhan Central Hospital

MALE VOICE:

Everyone knew it was human-to-human transmission. Even a fool would know. So why say there is no human transmission? This made us very confused. Very confused and very angry.

The hospital told us that we were not allowed to speak to anyone. They wouldn’t even let us wear masks. They said they were afraid of causing panic. I thought the leaders were stupid.

NARRATOR:

Around Wuhan, doctors and nurses began getting sick, a sign of human-to-human transmission. Some health workers later told Chinese media they tried voicing concerns to local and provincial officials.

YANZHONG HUANG:

I think the main concern is that what if it is a false alarm, right? Then if there’s chaos and instability and people panic, then they would look bad in the eyes of the central leaders. That is not good for their personal careers.

NARRATOR:

On Jan. 6, city and provincial officials began 12 days of annual political meetings in Wuhan.

DAKE KANG:

There are indications that Wuhan city officials did not want information about this outbreak to really spread because they really want things to go as smoothly as possible to make themselves look good.

There also could have been an order from the top down where they were saying basically get this under control but don’t tell anyone because we don’t want to alarm anyone.

I think it’s very possible that there was kind of a systemic failure. It’s a perfect storm of multiple failures happening at the same time in different parts of the government bureaucracy.

NARRATOR:

We asked the local and provincial governments for comment but did not receive a response. The Chinese central government insists it “took the most comprehensive, rigorous and thorough measures” and that by the 7th of January, Xi Jinping had issued epidemic response instructions, though the details of those instructions have not been made public.

As the virus continued to spread, the world outside Wuhan largely remained in the dark about what was going on.

SUI-LEE WEE:

I reported the first story, which was on Jan. 6. The two people I spoke to in Wuhan who were sick told me, “Oh, you know, we’re fine. No one in our family is sick.” And so I thought, “Oh, OK, it’s probably some pneumonia-like illness that’s not going to sweep around the world.”

I also spoke to a couple of experts. They also thought that it was not going to be that significant. Health workers were not getting sick, and no one had died at that point.

I believed that the Chinese government wouldn’t—would not think of covering up the way they did during SARS and that if the hospitals were overwhelmed there would be no way to cover that up.

I do wonder whether my first report conditioned people to think that this was not such a big deal after all.

Shenzhen

Southern China

ZHANG HAI:

[Speaking Chinese] I didn’t know that an epidemic was sweeping across Wuhan. I am Wuhanese born and raised, just like my father. I left Wuhan when I was very young and went to many other places.

NARRATOR:

Across China, most people were unaware of what was happening in Wuhan. Zhang Hai was making plans to take his 76-year-old father, Zhang Lifa, back to the city.

ZHANG HAI:

[Speaking Chinese] My father had a fall. The doctors said he needed to go to the hospital for an operation. I drove my father back to Wuhan because he’s entitled to state-funded health care there.

NARRATOR:

Zhang Hai checked his father into the People’s Liberation Army Hospital in central Wuhan to have his broken leg operated on.

ZHANG HAI:

[Speaking Chinese] They gave my father a general anesthetic. He woke up three days later. The doctors told me it was very successful. He recovered well and the color returned to his face.

In the hospital, the doctors were wearing regular masks. They had no other protective measures. If I’d known there was a coronavirus outbreak in Wuhan I definitely wouldn’t have driven my father back.

COVID Case Estimate

December 30, 2019: 2,300-4,000

January 6, 2020: 6,000-10,000

Northeastern Univ.

NARRATOR:

By Jan. 8, it’s estimated more than 6,000 people had been infected by the virus.

The Chinese New Year was just over two weeks away. Fifteen million people were expected to travel out of Wuhan alone during the holiday.

One of their top destinations abroad was Thailand.

Bangkok

NARRATOR:

Publicly the Chinese government was still saying that cases were linked to the Huanan market and there was no evidence of human-to-human transmission.

But Thai health officials were skeptical.

TANARAK PLIPAT, Thai Department of Disease Control :

China said that there is no evidence that the disease has human-to-human transmission, but we all know very well that for the pneumonias, usually there will be some human-to-human transmission, so that is what we prepared for. [laughs] So we started screening the passengers from Wuhan.

NARRATOR:

Bangkok’s main airport began temperature checks on all passengers from Wuhan, not just those who had been to Huanan market. On Jan. 8, a 61-year-old woman from Wuhan arrived for a tour of Thailand.

ROME BUATHONG, Thai Ministry of Public Health:

When she take an ear thermal scan, it is more than 38 degrees Celsius, and then we repeat again and also the temperature is still increasing.

NARRATOR:

When Dr. Rome interviewed the woman, he discovered an alarming detail.

ROME BUATHONG:

In the beginning we know only the Wuhan market is suspected source. And then she said, “I not go this market. Not contact with Huanan market at all.” So that is really the critical information for us, that the spreading may be generalized in Wuhan.

NARRATOR:

Thai health officials took a sample from the woman. They wanted to be sure it was same illness as the one spreading in Wuhan. The sample was sent to an expert on coronaviruses.

SUPAPORN WACHARAPLUESADEE, Virologist, Chulalongkorn Univ.:

Dr. Rome asked my lab to identity the disease of the unknown pneumonia. So this is our huge responsibility.

NARRATOR:

She quickly identified four short genetic sequences. But it wasn’t quite enough.

SUPAPORN WACHARAPLUESADEE:

All the four sequences were match to the bat SARS-like coronavirus. But I could not say that this is the cause of the disease. And at that time we are waiting for the whole genome sequence from China to confirm.

Geneva

NARRATOR:

Officials at the World Health Organization were also waiting for more information on the virus. Publicly, the WHO had been echoing China’s official position: that it was a viral pneumonia. But behind closed doors, something else was going on.

DAKE KANG:

The WHO starts to get concerned because they’re starting to hear the Chinese authorities know more. Oh, they had sequenced of the virus. They’ve identified what kind of virus it is, but they don’t know what’s going on. And that we know because The Associated Press obtained some recordings of internal meetings by WHO officials.

NARRATOR:

The Associated Press shared some of the leaked recordings with FRONTLINE. They show that officials were frustrated at China’s lack of transparency.

MARIA VAN KERKHOVE [on tape]:

We’re going on very minimal information. I know it’s clearly not enough for you to do a proper planning with it.

MIKE RYAN, Health Emergencies Programme, WHO [on tape]:

I think we need to shift gears now. We’ve all been, or some of us, have been here before. In 2003. This is exactly the same scenario, endlessly trying to get updates from China.

NARRATOR:

Dr. Mike Ryan, who was overseeing the response to the emerging outbreak, was worried that the WHO would be accused of failing to warn the world.

MIKE RYAN [on tape]:

The danger now, despite our good intent, it may be, especially if something happens, there will be a lot of finger-pointing

DAKE KANG:

The really pivotal moment comes around Jan. 8, when they hear that The Wall Street Journal is about to report that Chinese authorities identified a novel coronavirus, and this is information that the Chinese have not told the WHO.

NARRATOR:

The WHO was now getting critical information from the media, not from the Chinese government. Over the next 48 hours, Mike Ryan had a series of meetings with colleagues to discuss the mounting crisis.

MIKE RYAN [on tape]:

Where China can make a huge contribution to the world right now is the immediate sharing of genetic sequences and primers with other countries. But unless they share that information and knowledge with others it will probably not give them the best benefit. And it will certainly mean that other countries are going to have to reinvent the wheel over the coming days.

“There’s been no evidence of human-to-human transmission” is not good enough. We need to see the data, we need to be able to determine for ourselves the geographic distribution, the timeline, the epi curve and all of that. It’s absolutely important at this point.

DAKE KANG:

Those concerns are not something they ever aired publicly, and instead they basically deferred to China. They said, “Oh, China says that there’s this number of cases.”

NARRATOR:

The next day, a WHO representative went on Chinese state television.

GAUDEN GALEA, WHO Representative to China:

It appears that the cases have stopped, new cases have stopped after the market was temporarily closed. And we can see that there is no clear evidence of sustained human-to-human transmission. The sheer speed of the response in China, the quality of the closure of the hospital—the market, the extremely rapid investigation, shows the increase in capacity that China has acquired.

NARRATOR:

The WHO never publicly accused China of hiding information or breaking any of the International Health Regulations. We asked them why they didn’t take a tougher public line.

MARIA VAN KERKHOVE:

We have public discussion about the information that we have. We also have very direct conversations with countries privately, which are very strong in the sense of the information that we need. But we are the United Nations organization on health and we are—we have a diplomacy that we use, because this is really important that we work with all member states. We work with everyone everywhere.

Every day we would go back and we would ask for more information and we would receive information every day. Was it enough every single day? No, but I could say that for every country that we’ve dealt with in every outbreak that we have dealt with.

LAWRENCE GOSTIN:

WHO was caught in a really difficult bind. It could have publicly challenged China, or, and this is what WHO decided that it would do, to actually work with China behind the scenes, to try to coax them to cooperate.

You know, time and time again there have been countries that have violated the International Health Regulations. And director-generals, in succession, really never called out a country.

DAKE KANG:

Ultimately, the impression that the rest of the world got was just what the Chinese authorities wanted, which is that everything was under control. Which of course it wasn’t.

Shanghai

Eastern China

NARRATOR:

Six days had passed since Shanghai virologist Zhang Yongzhen had obtained the full genetic sequence of the virus. By now, Chinese state media had announced it was a novel coronavirus. But Zhang was still prohibited from publishing his data.

MALE NEWSREADER:

[Speaking Chinese] Lab tests have detected a novel coronavirus.

EDWARD HOLMES:

Once the Chinese authorities confirmed it was a coronavirus, at that point it seemed absolutely ridiculous that we couldn’t release the data. It was untenable that we were sitting on this information and not letting it go out. It just seemed wrong.

He was very stressed because he was under great pressure. He’s a Chinese citizen and he’s very— he’s a very proud Chinese citizen. He doesn’t want to do things that he thinks will be wrong for his country.

Sydney

EDWARD HOLMES:

On the Australian morning of Jan. 11, Zhang and I were talking on the telephone, and he was on a plane flying between Beijing and Shanghai. I said that we need to release it, it’s now or never. Really, we have to do this. And he said, “OK.”

So he sends me this email with a file with the sequence in, and I contact a colleague in Edinburgh, Professor Andrew Rambaut, and he established a website called Virological, which is used for rapid dissemination of data. It’s like 1:00 in the morning in the U.K. and we need to write some text saying what it is and where it comes from.

My hands were kind of—I remember I was sort of shaking as I was pressing the button. I could almost hear the hands of the clock ticking.

So then we posted it on Virological and I put a tweet out saying, “Here’s the first genome sequence.” So that bit was done extremely quickly. I just felt the weight of pressure just to get this out there.

The sequence release was a key moment because it told people “this is the pathogen, this is what it looks like. It’s a real thing. Here it is. And now we can start.”

NARRATOR:

The release of the sequence forced Beijing’s hand. Within hours, China’s CDC and National Health Commission made public the genetic sequences they’d obtained and shared them with the WHO.

The international community was now able to act.

On Jan. 13, German scientists published a toolkit for a test so other countries could check for cases.

FEMALE NEWSREADER:

A Chinese tourist in Thailand is the first confirmed case of the new pneumonia virus outside China.

DAKE KANG:

Researchers in the U.K. then quickly did modeling to figure out if there are these cases that are showing up outside of China, how many people are actually infected in Wuhan? And what they found was pretty alarming. It showed that there were probably thousands of people infected in Wuhan.

NARRATOR:

After the release of the sequence, Zhang’s lab was temporarily shut down for what the authorities called “rectification.”

In the Chinese government’s official account of how it responded, there’s no mention of Zhang’s role. They said that it took time to study and understand the virus and that they “wasted no time” in releasing the sequence to the WHO.

Wuhan’s hospitals were now treating hundreds of patients with respiratory symptoms. The health worker at Wuhan Central told us the emergency room was filling up.

Health Worker

Wuhan Central Hospital

MALE VOICE:

Every day there were several hundred people with fever arriving at our emergency department. Hundreds every day. I was definitely afraid. I realized that this illness was everywhere.

NARRATOR:

Patients were starting to die.

MALE VOICE:

Around me, one by one, my colleagues were becoming infected. All of us were definitely scared.

NARRATOR:

Although there were now hundreds of sick patients across Wuhan, they weren’t being logged in the CDC’s much-touted reporting system. The official case count had in fact been revised down to 41.

According to leaked documents from the city heath commission and Wuhan Central Hospital, local and provincial authorities were suppressing the numbers. They were only counting cases linked directly to the Huanan market. And only they, not the doctors, were authorized to confirm cases.

Health Worker

Wuhan Central Hospital

MALE VOICE:

At the level of the hospital we could not confirm a diagnosis, and I don’t know what level could actually confirm the diagnosis. So to say there were 41 confirmed cases I don’t think is incorrect. But if you’re talking about suspected cases, I guess that at that time there were already hundreds and hundreds.

NARRATOR:

During this period, the National Health Commission’s scientists on the ground in Wuhan were gathering extensive data about the outbreak and preparing a paper on their findings.

VICTOR SHIH:

At the very beginning of January, the central government had dispatched a team of leading infectious disease experts from the Peking University School of Medicine, that’s kind of like the Harvard Medical School of China, as well as from other leading universities. And so they arrived in Wuhan. They began to look at the clinical data that they had gathered up to Jan. 2.

NARRATOR:

The data covered all 41 official cases hospitalized by Jan. 2. It was an alarming picture. It turned out only two-thirds of cases were linked to the Huanan market. The first case had no link to any of the others. There were clusters of cases within families. The National Health Commission scientists concluded the virus could have acquired the ability for “efficient human-to-human transmission” and that there was potential for a pandemic.

VICTOR SHIH:

They had been working on this paper since early January and so they would have submitted an internal version of the paper to a senior official in China.

NARRATOR:

The Chinese government did not answer our questions about whether anyone had signed off on the paper. But the scientists it had appointed ended up sending a draft to the prestigious Lancet medical journal in London.

RICHARD HORTON, Editor-in-Chief, The Lancet:

When I read through that paper, I had nothing but fear, because the severity of the disease was shocking. I mean, these patients, they were rapidly deteriorating into multiorgan failure, admission to intensive care unit, a high mortality. The virus was triggering this massive inflammatory explosion, which was damaging the organs of their bodies. And when you see the severity of the illness combined with the signal of the risk of a global pandemic? Fear.

NARRATOR:

Horton said he held off publishing the paper while it was getting peer reviewed. In the meantime, Beijing did not make public its team’s findings, including that the virus was likely being transmitted from human to human.

RICHARD HORTON:

I think that what was happening was that very difficult interface between the message coming from the scientists and the politicians who are trying to manage that message internally for domestic security and externally in terms of its international relations, and I think that’s where the block took place. But I have no doubt that the scientists and doctors who were on the front lines knew exactly what they were dealing with.

January 14, 2020

Day 45

Officially Reported Cases: 41

NARRATOR:

In Beijing, the government secretly started to ramp up its response. Xi Jinping issued new instructions on the outbreak. They were passed down to the country’s local and provincial health departments.

DAKE KANG:

So The Associated Press’ global investigative team obtained some documents and shows that on Jan. 14, China’s top health official, Ma Xiaowei, he told the country’s public health institutions to prepare for a possible pandemic.

NARRATOR:

The documents contained warnings that the outbreak was likely to develop into a major public health event, China’s most severe challenge since SARS.

DAKE KANG:

They were saying things like clustered cases means that human-to-human transmission is possible. They were saying things like because of upcoming travel for China’s biggest holiday of the year, the Spring Festival, means that this virus could be spreading widely.

NARRATOR:

At train stations and airports around Wuhan, temperature checks began appearing. Hospitals across the country were told to start preparing. The government did not announce these new emergency measures to the public, but it did authorize state media to say that limited human-to-human transmission could not be ruled out.

MALE NEWSREADER:

[Speaking Chinese] Today in the early hours, Wuhan issued its latest statement on the coronavirus epidemic. The investigation shows that there is no clear evidence of human-to-human transmission. The possibility of limited human-to-human transmission cannot be ruled out. But the risk of human-to-human transmission is low.

LI QUN, CDC Emergency Center [on phone]:

[Speaking Chinese] For the general public, what’s more important is to protect yourself. Wear a mask if you go to the hospital. Pay attention to hand hygiene and ventilation. And reduce visits to crowded places.

DAKE KANG:

These documents reveal that central authorities were very alarmed about this virus by Jan. 14. But in public, again, they weren’t really raising the alarm. They say things like, in the run up to the two big meetings that China had every year, political meetings, “We have to maintain social stability.” There’s a big emphasis on that, and that really points to the authorities not wanting to freak people out for political reasons.

NARRATOR:

In its official timeline, the Chinese government says that at the time, there was great uncertainty about the new disease and that more research was needed to understand its mode of transmission.

Geneva

January 14, 2020

NARRATOR:

The WHO called its first press conference on the outbreak.

MARIA VAN KERKHOVE:

So good morning colleagues. Thank you for the opportunity to be here today with you. So just to provide a little bit of background about what coronaviruses are and what we are trying to do—

NARRATOR:

Publicly, the WHO had been sticking to the official Chinese line that there was no clear evidence of human-to-human transmission. But in front of the media, the agency’s coronavirus expert appeared to contradict that.

MARIA VAN KERKHOVE:

So far with the current virus we have limited human-to-human transmission. But what we are preparing for is the possibility that there will be, there could be.

That was my first press conference I’ve ever done. I presented the situation as I understood it and as we understood it from the data and as it relates to the guidance that we want to put out. And so when you have a respiratory pathogen, of course there would be human-to-human transmission. It’s just where is that happening and what is the extent.

NARRATOR:

News spread fast that the WHO had confirmed human-to-human transmission.

SUI-LEE WEE:

The first report came up from Reuters. They sent out a news alert that the WHO said that there was limited human-to-human transmission.

So I quickly sent an email to Geneva saying, “Can you confirm this?” and started writing the story, that the WHO had identified this as a virus that can spread easily among humans. And then they said “Oh”—they sent me an email to say, “Oh, it was a misunderstanding. The preliminary investigations conducted by the authorities have found no clear evidence of human-to-human transmission. There has been no evidence of limited human-to-human transmission.”

NARRATOR:

In a statement, a WHO spokesman told us they never intended to suggest that there was definitely human-to-human transmission happening. Despite the mounting evidence, the spokesman said WHO scientists were not on the ground so couldn’t make that determination officially.

MARIA VAN KERKHOVE:

We rely on the information that is provided to us. There’s always more information that we need. Always. Things were happening very, very quickly, and we were utilizing the information that we had, and we always go back to the countries to gather more information, and China was no different.

SUI-LEE WEE:

I do appreciate that it’s early on in the pandemic and there was this—there was what we call the fog of war, people are trying to understand what’s happening and you don’t want to put out information before you don’t really know what’s happening. But it made a lot of us think, me included, that this wasn’t such a big deal after all. So I just left it at that and scrapped the story.

January 18, 2020

Day 49

Officially Reported Cases: 62

NARRATOR:

Outbreaks had now begun in other parts of China. People were turning up in hospitals in the major cities of Beijing, Shanghai and Shenzhen. Chinese New Year was approaching, and the country was on the move.

VICTOR SHIH:

What typically happens is that in the run-up to the Chinese New Year, close to 300 million migrant workers leave the cities where they worked to return to their hometowns to celebrate the Lunar New Year with their parents and loved ones.

NARRATOR:

The Chinese government had already issued its internal warnings to health officials about a possible pandemic, but they did not order a lockdown.

VICTOR SHIH:

We don’t know why there was this delay. I think the Chinese government was coming up with a plan of how to deal with the pandemic. My favorite speculation I guess is that they made the decisions to hide the news so that the Spring Festival migration can proceed without any hiccups, without any panics. There’s actually a very decent public health reason. If they had announced a lockdown, that would have meant that hundreds of millions of migrant workers would have been trapped in the major cities, which would have great implications for both public health but also for stability.

NARRATOR:

In Wuhan, life continued as normal. There was a college careers event, performances and a mass banquet attended by thousands.

FEMALE SPEAKER:

[Speaking Chinese] Wishing everyone an auspicious and lucky Year of the Rat.

VICTOR SHIH:

It was unnecessary. The Wuhan government could have cancelled the banquet. Reporters talked to community workers, and they were afraid, and they tried to convince district-level officials to cancel the banquet, but the district-level officials would not do it. They refused to do it.

My guess is that the order to not do anything unusual came from the very top, some very senior-level officials in Beijing.

NARRATOR:

On Jan. 19, the head of the Wuhan CDC was still reassuring the public.

MALE SPEAKER:

[Speaking Chinese] The clinical manifestation of patients generally is mild. So we can have the initial impression that the transmissibility of this new coronavirus is not strong. The epidemic is preventable and controllable.

NARRATOR:

Neither Wuhan officials nor the Chinese central government have specifically answered for why they were still downplaying the outbreak and allowing these mass gatherings and travel.

January 20, 2020

Day 51

Officially Reported Cases: 198

NARRATOR:

By Jan. 20, it’s estimated that more than 80,000 people in the country were infected.

On state TV, the government finally acknowledged that the virus was spreading human to human. The news was delivered by the revered 83-year-old doctor Zhong Nanshan.

MALE NEWSREADER:

[Speaking Chinese] What are the current conclusions regarding human-to-human transmission?

ZHONG NANSHAN:

[Speaking Chinese] Before, there was the risk of human-to-human transmission, or something like that. Now, the current data shows that there is definitely human-to-human transmission. So now we can say there is definitely the phenomenon of human-to-human transmission.

SUI-LEE WEE:

Zhong Nanshan is very respected. To have him go on CCTV to disclose this, to be the first person in China to say that this is what was going on, was jaw-dropping. And that was when cases started to skyrocket in Wuhan and the numbers multiply tenfold, very fast.

FEMALE NEWSREADER:

[Speaking Chinese] An epidemic of novel coronavirus pneumonia has occurred in Wuhan, Hubei Province and other areas. As of 18:00 on Jan. 20, the total reported cases in China is 224, including 217 confirmed cases.

Wuhan – 198.

LAWRENCE GOSTIN:

It was always going to be very difficult to control this virus, from day one. But by the time we knew that it was transmissible human to human, I think the cat was out the bag—it had already spread. That was the shot we had, and we lost it.

January 23, 2020

Day 54

Officially Confirmed Cases: 571

NARRATOR:

At 10:00 a.m. on Jan. 23, Wuhan was put on lockdown.

MALE NEWSREADER:

The city at the heart of a public health crisis in China is shutting its public transport network.

FEMALE NEWSREADER:

Flights canceled, trains halted, highways blocked by police.

FEMALE NEWSREADER:

Eleven million residents have been told to stay put.

NARRATOR:

CDC Director George Gao went before the media.

GEORGE GAO:

I’ll be here, OK? Stay calm. We have the virus there. The virus is crazy. We don’t want to be crazy. Calm. Calm down.

[Speaking Chinese] Everyone likes to compare it with SARS. But actually, this virus is not as strong as SARS. We’re seeing many mild cases.

NARRATOR:

Despite Gao’s assurances, doctors on the front lines were confronting the reality that COVID-19 was much more transmissible than SARS. Hospitals were overwhelmed. By one estimate, Wuhan Central Hospital received over 1,500 patients on a single day.

Health Worker

Wuhan Central Hospital

MALE VOICE:

There were some patients who didn’t need to die. There was nothing we could do. The medical resources were just too tight. It erupted too fast, and then there were just too many people infected. Without ventilators, without specific drugs, even without enough manpower, how were we going to save people? If you are unarmed on the battlefield, how can you kill the enemy?

I believe that the true history needs to be remembered. We need to learn the lessons so that this doesn’t happen again.

NARRATOR:

At the army hospital in Wuhan, Zhang Hai’s father, Zhang Lifa, was recovering from his leg operation. But he’d developed a fever.

ZHANG HAI:

[Speaking Chinese] “Positive.” When I heard them say “positive,” I realized they meant the novel coronavirus. My heart sank.

My father had already slipped into a coma. The doctor proposed removing his ventilator. But I wouldn’t agree. I didn’t want to give up. I still hoped for a miracle. So I kept vigil by his bedside.

On the morning of Feb. 1, I left to find someone to get him burial clothes. I got a call from the hospital. They told me to hurry back quickly. After a while the doctor came out to inform me that my father had died.

It was me personally who brought him to his death. So I feel extremely guilty. At the same time, I’m really angry. Normally, ordinary people believe the government. So when the government says on television that it’s “preventable and controllable,” and when experts say there’s no human-to-human transmission, many ordinary people believe them.

If the Wuhan authorities hadn’t concealed it, my father wouldn’t have left me. Because they covered it up, so many people lost their precious lives.

NARRATOR:

The Chinese government says fewer than 5,000 of its citizens have died from COVID-19, but many outside experts say the number is likely much higher.

Among the dead: eye doctor Li Wenliang, who had first raised the alarm about an outbreak.

Around the world, the death toll is over 2 million and still climbing.

MALE NEWSREADER:

Exactly one year ago today the first COVID case in this country was confirmed. By next month, more than half a million lives could be lost to the virus.

FEMALE NEWSREADER:

One person now dying every six minutes.

WANG LINFA:

Jan. 20 is the dividing line. Before that the Chinese could have done much better. After that, the rest of the world should be really on high alert and do much better.

DAKE KANG:

I don’t think it’s clear right now exactly how history is going to view this pandemic. If the Chinese authorities had acted earlier, would it have made a difference? I think that’s the key question. And I don’t think there’s an answer to that right now. It might have been a case where it was already too late by the time we realized that this virus was spreading. But I think what we can say based on what we know right now, it’s clear that there were mistakes that were made. There were clear delays, and many people did suffer the consequences.

NARRATOR:

The Chinese government continues to defend its response to the outbreak.

XI JINPING:

[Speaking Chinese] After making painstaking efforts and enormous sacrifice, China has turned the tide on the virus and protected the life and the health of our people. All along we have acted with openness, transparency and responsibility. We have provided information to the WHO and relevant countries in a most timely fashion.

LAWRENCE GOSTIN:

If the great coronavirus pandemic of 2020 teaches us anything, it teaches us that we absolutely have to have the kind of open sharing among scientists and governments about all information. We’re all in it together.

WANG LINFA:

What we need is early warning and work together, share information, transparency. Now all of this need a culture change and need the political landscape to change, and unfortunately, right now, we’re going the opposite direction. I mean, COVID-19 is not going to be the last one, right? Everybody knows that.

“Go world”

“Go Wuhan”

“Go China”

**********

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