[Note: A shorter, revised and on a few issues more up to date version of this piece has been published by Quillette as a four-part essay. The version on Quillette is more polished and a bit less polemical, but this one has more technical details on some issues, so which version you should read depends on what you’re looking for.]
According to a poll conducted in France, Italy, Spain, the UK and the US at the end of March, a majority of the population in each of those countries believe that China is at least somewhat to blame for the pandemic and, in both the UK and the US, a plurality believe it’s significantly to blame. Another survey done in the US at the end of April found that a plurality of people believe that SARS-CoV-2 was probably or definitely created in a lab. At the beginning of that month, another poll had found that a majority of Americans believed that China was not reporting the impact of the epidemic over there accurately, that it was responsible for the spread of the virus and that it should be required to pay for it. Although people disagree about what exactly China lied about, there is widespread agreement in the media that it engaged in some kind of cover-up about the epidemic. In the US, many public officials, including Donald Trump, explicitly accused China of various manipulations. As we shall see in the rest of this essay, stories based on leaks from intelligence agencies that allege China is lying about the pandemic are regularly published in the press, so although many of them have already been debunked, it’s not surprising that so many people believe China is lying.
For instance, back in May, the Daily Telegraph of Sydney published a story about a dossier allegedly put together by the intelligence agencies of several Western countries (the US, Australia, New Zealand, Canada and the UK), which it summarized like this:
[The dossier’s] major themes include the “deadly denial of human-to-human transmission”, the silencing or “disappearing” of doctors and scientists who spoke out, the destruction of evidence of the virus from genomic studies laboratories, and “bleaching of wildlife market stalls”, along with the refusal to provide live virus samples to international scientists working on a vaccine.
It later turned out that it was just a document authored by the US State Department based on press reports and not on any intelligence, probably leaked to the Australian press with the intention that it would find its way back into the US and give the impression that foreign intelligence agencies were backing the claims made by Trump’s administration, but similar claims continue to be made on a regular basis and, as we have seen, many people believe them.
In this essay, I will discuss the various accusations that have been made against China in connection to its role in the pandemic and review the evidence in favor of those claims, in order to determine whether they have any merits. There are many reasons to dislike the Chinese government, but specific accusations should be backed by sufficient evidence. After carefully reviewing the evidence, I came to the conclusion that, while there is some truth to some of the accusations made against China in connection to the pandemic, they have been wildly exaggerated and most of them are complete nonsense that doesn’t stand up to scrutiny. (In some parts of this essay, I do some data analysis and I have put the code on GitHub, to make sure that people can reproduce my results and detect any mistake I might have done.) It’s important to examine whether those claims are true because, if they were, it could mean that a large number of deaths and/or a great deal of economic hardship could have been avoided, had China been more forthcoming about the outbreak. In my view, this fact alone should lower your prior that China engaged in some kind of massive cover-up, because such a manipulation would probably be discovered and eventually lead to a backlash in the rest of the world. So while this consideration doesn’t speak much to the possibility that China lied in minor ways, it should make you somewhat skeptical that it engaged in the kind of large-scale manipulation people claim it did.
However, this is hardly dispositive, if only because governments don’t always act rationally. There are plenty of examples where a government engaged in a cover-up even though it should have known that the truth would eventually come out and that it would be even worse for it then. So we can’t assume that, because it would almost certainly back-fire eventually and the Chinese authorities should have known that, they didn’t engage in the kind of cover-up many people claim they did. Moreover, as we shall see, the Chinese regime is not a unitary agent. It consists in many different people at various echelons who don’t always face the same incentives and don’t have the same information, so it may not have been irrational for some of them to lie. In addition, there are other considerations that, on the contrary, should probably raise our prior that China manipulated the data somewhat. In particular, China is an authoritarian country where the authorities routinely engage in heavy censorship, which makes it less likely that, if they had in fact engaged in a massive cover-up, we’d be able to find out. Moreover, during the SARS epidemic in 2003, the Chinese authorities had covered up the scale of a problem for several weeks, so there is a precedent for not trusting China on that kind of issues.
To be honest, while I obviously don’t claim there are no differences in that respect between authoritarian regimes like China and liberal democracies, I believe this argument is less convincing than most people think, because not only is censorship not as effective as people tend to think (people in China are not stupid and information does get out despite attempts to suppress it), but widespread disinformation can and frequently does take place in countries where the press is relatively free. (In fact, as I point out later in this essay, this has arguably been the case with the pandemic in most Western countries and, as I hope this piece will demonstrate, the narrative about the extent of China’s alleged cover-up of the outbreak is another example.) However, this is a story for another time, so for the purposes of this discussion I’m just going to say that China’s lack of transparency in general does give us some reason to be suspicious but that, like the argument pushing in the opposite direction I mentioned above, it’s hardly conclusive and that it would be completely irrational to believe that China engaged in a massive cover-up of the epidemic on that ground alone. So let’s examine the evidence and try to determine whether the accusations that people make against China are justified.
First, I will discuss what the evidence shows about when exactly the Chinese authorities found out that a new virus had caused a cluster of viral pneumonia in Wuhan, which they didn’t reveal until December 31. People claim that the Chinese government knew what was going on in Wuhan long before they made public the existence of a new coronavirus, which was responsible for the outbreak of pneumonia in the area, but covered it up. However, while some things could have been handled better and in some cases, though hardly all of them, probably would have in a country with more liberal institutions, the evidence doesn’t suggests that it took China particularly long to identify SARS-CoV-2 as the cause of the outbreak and make it public. In this discussion, I will rely a lot on the work done by Chinese journalists at the beginning of the crisis (as well as on stories published by foreign outlets), which I think make it possible to get a pretty good sense of what happened during the early phase of the outbreak. People often talk as if China were totally closed and the government were able to perfectly control information, but as we shall see this is very far from the truth.
According to the South China Morning Post, which claims to have seen official Chinese documents about this, the first case of COVID-19 was traced back to 17 November 2019. This is roughly consistent with genetic evidence, which suggests SARS-CoV-2 originated in late November. But to be clear, because many people misinterpreted this story, it doesn’t mean that the Chinese authorities knew about the outbreak back then, let alone that it was caused by a new coronavirus. In fact, not only does the story not claim that, but there is no doubt that neither the Chinese authorities nor anyone else did at the time. Indeed, if the virus didn’t occur in humans until November, there would only have been a handful of infections at the time and it’s hard to see how anyone could have understood what was going on. Rather, if the South China Morning Post’s article is accurate, what happened is that after the SARS-CoV-2 was identified as the cause of the outbreak of pneumonia in Wuhan, the Chinese authorities tried to find out who among the contacts of the known cases may have been infected earlier and they found a case going back to 17 November 2019. From this story, it’s impossible to tell whether they just suspect this person had been infected by SARS-CoV-2 because they determined based on interviews that he or she was sick at this date with symptoms consistent with COVID-19 or because they performed serological tests showing this person had developed immunity to SARS-CoV-2, but the language used in the article suggests they are not sure.
Incidentally, this is why the ABC News story according to which “U.S. intelligence officials [had warned] that a contagion was sweeping through China’s Wuhan region, changing the patterns of life and business and posing a threat to the population” in late November didn’t make any sense. Unless the outbreak started much earlier, which nothing indicates and is contradicted by phylogenetic evidence, there is absolutely no way the U. S. intelligence could have noticed that a pandemic had already started at the time. Rather, this is probably yet another example of a misleading leak by people in the U.S. intelligence community to make Trump look bad, since the authors of that story predictably conclude that it would mean the federal governments could have taken steps much earlier than we thought to prepare for a pandemic. Personally, I put more faith in molecular clocks than in anonymous leaks by people who clearly have a political agenda and have a terrible track-record of leaking misleading information about Trump, even if journalists apparently don’t. Indeed, the story was quickly denied by the Director of the National Center for Medical Intelligence and this was later confirmed by a CNN story (even though it tried to make it sound like the original story was nevertheless right somehow), but not before scores of journalists working for every major news organization enthusiastically shared it. Note, by the way, that none of those people will ever be accused of spreading “fake news”.
According to the World Health Organization, which relayed information it had received from the Chinese government, the first COVID-19 patients were hospitalized in Wuhan at the beginning of December. Even if the Chinese health authorities are monitoring suspicious outbreaks of respiratory illness very closely, which I’m sure they are, you wouldn’t expect them to have understood what was going on right away. Of course, given that ultimately this information comes from the Chinese government, it should be taken with a huge grain of salt, but even the South China Morning Post, which claims to have talked to “whistle-blowers from the medical community” about this, Chinese doctors didn’t realize they were dealing with a new disease until late December. This is also what the Wall Street Journal, which talked with several doctors in Wuhan, reported in this story. The WHO was informed on 31 December 2019 that a cluster of pneumonia of unknown etiology had been identified in Wuhan. (However, as we shall see later, it wasn’t by the Chinese authorities.) But Alex Azar, the U.S. Health & Human Services Secretary, said during a press conference on 20 March 2020 (at 1:02:20 in the video) that Robert Redfield, the Director of the American CDC, was alerted by the Chinese on 3 January 2020. According to the China CDC Weekly, SARS-CoV-2 was sequenced on 3 January 2020 at the National Institute of Viral Disease Control and Prevention, so probably about one month and a half after the first human infection. As reported by the press at the time, the discovery was made public a few days later, on 9 January 2020. It’s unclear when the WHO was informed of that discovery exactly.
I will go back on this timeline in more detail soon, but let’s pause for a moment and consider the import of the delay between the first known human infection and the announcement that SARS-CoV-2 had been identified as the cause of the outbreak in Wuhan by China. In order to get a sense of how plausible the claim that the Chinese authorities knew what was going on long before they informed the rest of the world is, I think it’s useful to compare the timeline of their response to the outbreak of COVID-19 with that of the response to the pandemic of swine influenza by the U.S. authorities in 2009. The earliest known onset of a case that was later confirmed as caused by the virus was a person in Mexico who reported onset of illness on 17 March 2009, but a study published in 2012 was able to identify 3 unrelated clusters of influenza caused by the virus in California at the end of March, including one person who reported onset of symptoms on 21 March 2009. Hence, as the authors of the study note, community transmission probably started earlier than that even in the US. But the CDC only identified the virus on 14 April 2009, after their received a sample from a 10-year-old boy who lived in California. This was confirmed on 17 April 2009, after the virus was found in another sample, taken on a 9-year-old girl also living in California but with no connection to the first case and who started having symptoms on 25 March 2009. The U.S. reported the discovery to the WHO on 18 April 2009 and published a report about it on 21 April 2009.
Based on this timeline, even in the most favorable scenario where community transmission started in California around mid-March, it took about a month before the U.S. health authorities were able to identify the swine influenza virus that started to spread among humans in the Spring of 2009. On the other hand, as we have seen above, if we accept the official timeline provided by the Chinese health authorities, it probably took them about one month and a half to identify SARS-CoV-2 as the cause of the outbreak of pneumonia in Wuhan. Given the role that chance plays in that sort of things, it’s not obvious to me that the CDC would necessarily have done better if the outbreak had occurred in the U.S. Moreover, it’s worth noting that, according to its website, the Chinese CDC had a staff of only 2,120 for a population of almost 1.4 billion in 2016, whereas in 2012 the American CDC employed 11,223 people for a population of about 320 million. I wasn’t able to find data on the Chinese CDC’s budget, but since the American CDC had a staff more than 20 times greater per capita than the Chinese CDC, I think it’s fair to say that it has vastly greater resources that no doubt make it much easier to monitor outbreaks of infectious diseases.
In both cases, again if we accept the official timeline about the discovery of SARS-CoV-2, it took about a week after the virus was first sequenced before the discovery was made public. This point is important because I hear a lot of people claim that, since the Chinese health authorities identified SARS-CoV-2 as the cause of the outbreak on January 3 but didn’t inform the rest of the world until a few days later, they were evidently trying to cover it up. However, as we have seen above, it took the U.S. health authorities the same amount of time to inform the WHO after they first sequenced the virus responsible for the swine influenza pandemic in 2009. It’s perfectly normal that the Chinese didn’t make their discovery public immediately after the virus was first sequenced. This isn’t because they were trying to cover things up, it’s because sequencing the virus was not enough to prove that it was responsible for the outbreak of pneumonia in Wuhan. As the researchers who did the discovery explain in this paper, it was only the first step of a much longer process, which also involved isolating the virus, observing cytopathogenic effects it produced after infecting susceptible cells, performing serological tests, etc. Presumably they also had to test the samples for other pathogens to rule them out as the cause of the illness. All of that takes a lot of time even if you are trying to go as fast as you can.
Beside, although they didn’t release much details until the discovery of the virus was announced on January 9, the Chinese didn’t hide that they were trying to identify the pathogen responsible for the outbreak in Wuhan during that period. On January 5, the Wuhan Health Commission published a statement about the outbreak, which said that “respiratory pathogens such as influenza, avian influenza, adenovirus, SARS and Middle East Respiratory Syndrome (MERS) [had] been excluded” and that “pathogen identification and etiology tracing work [were] still in progress”. Based on the few details that Chinese officials had released, as well as local media reports, plenty of people were already conjecturing that a new coronavirus was responsible for the outbreak at the time. As early as January 3, a professor of medicine at the Chinese University of Hong Kong had already explained in a radio interview that, according to a professor at Peking University he’d talk to, a new coronavirus was suspected as the cause. Thus, if the Chinese authorities were trying to cover this up, they were doing a terrible job at it.
As a search on Twitter reveals, among the few people who actually cared about this at the time, mostly virologists and China watchers, there were already complaints that China was being too slow to release what they had found. Of course, they were right that sequencing the genome of the virus should be fast, especially with today’s technology. But as some virologists also noted at the time, it’s understandable that, before announcing that a new coronavirus was responsible for the outbreak in Wuhan, the Chinese health authorities would want to make sure they had gotten it right. As I already explained, sequencing the virus is only a first step, it doesn’t tell you that the RNA you found belongs to the virus that is actually responsible for the outbreak. You can’t even be sure that a single pathogen is responsible for all the cases of pneumonia before you have tested several samples and done a lot of work. As Florian Krammer, professor of microbiology at the Icahn School of Medicine at Mount Sinai, noted in this thread (which I find particularly helpful to get a sense of the kind of debates virologists were having at the time), one thing you’d want to rule out is that co-infections are actually responsible for the illness. As Eddie Holmes, a virologist at the University of Sidney, noted in reply to him, something like that had actually happened with SARS, which people initially suspected of being caused by a metapneumovirus before they realized SARS-CoV-1 was responsible. Again, this is complicated work, but people don’t know that and they don’t like the Chinese Communist Party, so they’re quick to assume a conspiracy where there was none.
Thus, when I compare the response to the pandemic of swine influenza by the U.S. authorities in 2009 to the response to the outbreak of COVID-19 by the Chinese authorities (up to the point where the virus responsible for the outbreak was identified), the narrative that the Chinese government knew that a new coronavirus was responsible for the outbreak long before it informed the rest of the world strikes me as totally implausible. The Chinese authorities seem to have identified SARS-CoV-2 as the cause of the outbreak of pneumonia in Wuhan and informed people outside of China in roughly the same amount of time it took the U.S. authorities to do the same with the swine influenza in 2009 after it reached California. But they did so with far less resources, so unless you assume that the Chinese health agencies are staffed with geniuses and/or that the people working at the CDC have no idea what they’re doing, I don’t think it’s reasonable to think they had figured out exactly what was happening long before they told the rest of the world. (I think China should allocate more resources to the surveillance of emerging infectious diseases, so the Chinese government can probably be criticized for that, but this doesn’t mean that it lied.) The truth is that it’s not easy to figure out that kind of things and, even with a lot of resources, it takes some time before the cause of the outbreak can be identified.
However, although the idea that China had already identified the virus responsible for the outbreak weeks before it publicly announced the discovery is ridiculous, there is compelling evidence that SARS-CoV-2 had already been sequenced by private genomics companies before 3 January 2020, when it’s supposed to have been sequenced for the first time according to the Chinese authorities. The Chinese media outlet Caixin published a very detailed article in Chinese laying out that evidence in February. Apparently, it’s no longer available, possibly because it was censored by the authorities, but it was archived and then translated by a Chinese dissident who now lives in the U.S. (Another piece on the same topic is still up on the English-version of Caixin, but it’s slightly less detailed overall, although it contains a few details that are not in the Chinese-language article. The Associated Press published a story in June that confirmed most of what Caixin had revealed back in February. The New York Times also published a very informative article in March on what went wrong with the reporting system that China had created after the SARS epidemic in 2003.) As this article explains, on 24 December 2019, a sample was collected on a patient at Wuhan Central Hospital and sent to a private genomics company for analysis using next-generation sequencing. According to the article, after analyzing the genetic material the sample, this company was able to sequence a genome that was 79% similar to SARS-CoV-1 on December 27, the virus that caused the 2002/2004 SARS outbreak. The company did not send back results but immediately called Zhao Su, head of respiratory medicine at the hospital (who had sent the sample), to inform him of their discovery.
I actually find this story very convincing for several reasons. First, Zhao Su actually confirmed it on the record, which given the risk I can’t imagine he would have done if the story weren’t true. (Caixin also claims that Vision Medicals, the company identified by Caixin as having sequenced the virus, also confirmed the story in a social media post, but it doesn’t give a link and I wasn’t able to find it.) Moreover, a paper that was published in the Chinese Medical Journal on 11 February 2020 and co-authored by someone working at Vision Medicals explains how SARS-CoV-2 was identified by next-generation sequencing in samples taken on 5 patients, including one whose sample was collected on 24 December 2019. (I was able to find the email address of the co-author of that study working at Vision Medicals, so I contacted him to ask for confirmation, but he didn’t reply to my email.) Of course, it’s possible that Caixin wrote the details of the story to fit this evidence, but the fact that, even according to the published study, the sample was taken on 24 December 2019 makes the claim that SARS-CoV-2 had already been sequenced by 27 December 2019 very plausible. Guangzhou, where Vision Medicals is based, is only a 10 hours drive from Wuhan, so presumably it would have received the sample on the day after it was collected or perhaps even on the same day. Furthermore, next-generation sequencing is very fast, so it seems plausible that the analysis was completed by 27 December 2019. In any case, since according to the paper the patient had already been in ICU for 2 days at the time and diagnostic was therefore urgent, it seems very implausible that it still wasn’t done by 3 January 2020, when the virus is supposed to have been sequenced for the first time. Finally, in the piece it published in June, the Associated Press claims to have independently confirmed this story.
What is less clear is how much the Chinese health authorities knew about this. According to Caixin, Vision Medicals shared the data with Chinese Academy of Medical Sciences at the time and company executives even went to Wuhan a few days after the virus had been sequenced, where they presented their results to local hospital officials and disease control authorities. But this claim is based on a post that was allegedly published on WeChat, a Chinese social media platform, at the end of January, whose author claimed to be working for a private company located in the same city as Vision Medicals. This is very weak evidence and I think it should be taken with a huge grain of salt. The only independently verifiable evidence that Caixin adduces is that one of the co-authors of the Chinese Medical Journal study mentioned above works for the Chinese Academy of Medical Sciences, which is true but doesn’t really prove anything. However, the Associated Press claims to have independently confirmed that story, so I think it’s safe to conclude that, sometime after December 27 (it’s hard to say exactly when), the local health authorities had been informed that RNA belonging to a new coronavirus related to SARS-CoV-1 had been found in a sample collected on a patient with pneumonia in Wuhan. (It’s also likely that some people at the Chinese Academy of Medical Sciences had been told about it, but they probably didn’t inform the national health authorities, since as we shall see the Director of the Chinese CDC didn’t find out until December 30 and apparently he learned about the outbreak through social media leaks I will discuss shortly.) In fact, as I’m now going to explain, it seems clear that, by the end of December, the health authorities in Wuhan knew that a new coronavirus had been discovered in samples taken on patients suffering from pneumonia of unknown etiology in local hospitals.
Indeed, Caixin goes on to explain that, after Vision Medicals sequenced the genome of SARS-CoV-2 on 27 December 2019, a sample collected on another patient was sent to a different private genomics company based in Beijing, which mistakenly identified the virus in the sample as SARS-CoV-1. According to Caixin, the test results were sent back to Wuhan Central Hospital, where they were eventually seen by several doctors. Apparently, they were initially received by Ai Fen, director of the emergency department at Wuhan Central Hospital, who sent them to several other doctors in Wuhan. One of them was Li Wenliang, an ophthalmologist at Wuhan Central Hospital, who shared them on 30 December 2019 with his medical school classmates in a private WeChat group. At first, he said that 7 patients who had contracted SARS at Huanan Seafood Market were currently isolated at Wuhan Central Hospital, but he later clarified that, although they had been infected by a coronavirus, the exact virus was still being sybtyped. Screenshots of what he said in that group eventually made their way to Chinese social media. (You can find a link to the screenshots, as well as a translation, on Li’s Wikipedia entry.) A few hours later, Xie Linka, a doctor at Wuhan Central Hospital, wrote a similar message in another WeChat group. (You can find a copy of the message, transcribed from a screenshot in another Caixin article, on her Wikipedia entry.) Although both Li and Xie said that it was probably another, related but different from SARS-CoV-1 (which incidentally suggests they heard information about the results of the analysis conducted by Vision Medicals and not just those of the Beijing-based company that mistakenly concluded the virus was SARS-CoV-1), the rumor started to spread on social media that SARS was back in Wuhan.
Both Li Wenliang and Xie Linka, as well as 5 other doctors (but not Ai Fen apparently, although she was rebuked by her superiors at Wuhan Central Hospital), were reprimanded by the police a few days later for spreading “false rumors”. Li was also forced to sign a letter of admonition in which he acknowledged he’d acted inappropriately and promised not to do it again. However, despite what a lot of people say, none of the doctors seem to have been detained at any point. (On 29 March 2020, the Australian TV programme 60 Minutes reported that Ai Fen was missing, a claim that was immediately repeated by other media. But except for the fact that journalists hadn’t been able to reach her, which doesn’t really prove anything, there doesn’t seem to be any evidence that she was ever detained. She has since then posted a video on Weibo assuring that she was fine and, on April 13, a French journalist found her at her post in Wuhan Central Hospital.) Note moreover that, although everyone calls Li Wenliang a “whistle-blower”, it’s not really accurate. There is no evidence that he ever intended to inform the public that a new coronavirus might have caused pneumonia in several patients at Wuhan Central Hospital, he just privately told some of his friends and his messages were leaked on social media. (In fact, in one of his messages on WeChat, Li specifically asked the members of the group not to circulate the information outside the group.) I don’t say to disrespect his memory, it’s just the truth. The problem with that language is not just that it’s inaccurate, but that it’s inaccurate in a way that fuels the narrative that Chinese officials were engaged in a conspiracy to hide the discovery of the virus at the time, which as we shall see is unsubstantiated. Indeed, while I don’t want to defend Wuhan’s police department, because I don’t think what it did is defensible, despite what many people claim, their actions are obviously not proof of such a cover-up.
On the same day, the virus was sequenced at the National Institute of Viral Disease Control and Prevention, which would lead to a public announcement a few days later. As I noted above, Chinese health officials also talked to the Director of the American CDC about the outbreak in Wuhan on January 3, although we don’t know exactly what they told him. Moreover, as we have seen, social media were already full of speculations that a new coronavirus related to SARS-CoV-1 was responsible for the outbreak. So as I already pointed out, if the Chinese health authorities were trying to cover it up, they were doing a spectacularly bad job at it. Again, if you just put yourself in the shoes of the local authorities, it’s not difficult to come up with a far more plausible explanation. As we have seen, after Li and Xie alerted their colleagues/classmates on WeChat and their messages were leaked on social media, the rumor that SARS was back in Wuhan instantly started to spread. This rumor was actually false and it’s understandable that the authorities were concerned that it would cause a panic. (As we shall see, despite a widespread narrative to the contrary, it’s also true that, at the time, they didn’t know for a fact that human-to-human transmission was possible.) This kind of concern is hardly specific to authoritarian countries like China, the authorities also worry about that in democratic countries. It’s just that, in a police state like China, instead of complaining about “fake news” and/or asking Twitter to take down your posts, they will publicly admonish you and force you to sign a Mao-style confession letter. Obviously, this is bad, but it’s not evidence of a cover-up.
On the same day Li and Xie alerted their colleagues/classmates on WeChat and the rumor started to spread, the local health authorities issued a notice that was sent to every hospital in Wuhan, warning them that several patients with pneumonia and links to Huanan Seafood Market had been admitted to various hospitals and asking them to monitor similar cases. Caixin and several other media claim that it was prompted by the leak of Li’s messages on social media. This is not implausible, but as far as I can tell, we don’t know that for a fact. The Chinese version of Caixin’s report also explains that, on December 27-29, the local health authorities had received several reports from various hospitals in Wuhan about people being admitted with cases of pneumonia. There is no evidence that anyone had noticed the cluster until that time, so it’s quite possible the local health authorities would have issued that notice anyway. In fact, they surely would have done it at some point, unless you think they are stupid enough to just sit and do nothing after they have realized that a new, potentially very dangerous virus had started to circulate in their jurisdiction. Perhaps the rumor that started to spread after the messages of doctors leaked on social media accelerated the process, but we have no way to know.
In any case, what seems clear is that it wasn’t until then, at the end of December, that medical professionals in Wuhan started realizing that something unusual was going on. This is important because a lot of people claim that China knew a new coronavirus had emerged in Wuhan long before that. But there is no evidence of that and the evidence we have shows it’s almost certainly false. Of course, a few people with COVID-19 started being hospitalized at the beginning of December, but at the time nobody suspected that a new virus was the cause of their illness and there is nothing remotely surprising about that. However, it seems clear that, by the end of December, the local health authorities had received information that provided very clear hints that a new virus had started circulating in Wuhan and might have caused pneumonia in several patients that seemed connected to Huanan Seafood Market. It’s also clear that, upon receiving that information, they tried to make sure it didn’t leak to the public, pressuring doctors to keep that information to themselves and reprimanding those who didn’t. But this doesn’t mean they were trying to hide the existence of the outbreak, which in any case was bound to become public at some point, as opposed to controlling the information about it. In fact, they didn’t order doctors not to share information with the public until after some of them inadvertently did, which gave rise to the rumor that SARS was back in Wuhan. Again, this rumor was false and likely to start a panic, so it’s not surprising they took steps to prevent something like that from happening again.
People have recently made a big deal out of the fact that, despite what the WHO had initially claimed, it wasn’t warned about the outbreak in Wuhan by the Chinese authorities but picked up the news on its own, something it implicitly admitted by quietly updating its “Timeline of WHO’s response to COVID-19“. But this doesn’t have the far-reaching implication people think it does and, in particular, it obviously doesn’t mean that China was trying to cover-up the outbreak. As the WHO now admits, it learned about the outbreak on December 31 because the Wuhan Municipal Health Commission made a public statement statement about it on Weibo, after the rumor that SARS was back in Wuhan started to spread. Reuters even published a dispatch about the statement at the time, so it’s not surprising that people at the WHO noticed. Moreover, the WHO’s Epidemic Intelligence from Open Sources picked up a post on ProMED, which contained a translation of a news report published by SINA Finance, a Chinese media specialized in financial news that had apparently obtained the notice sent to every hospital in Wuhan by the local health authorities I mentioned above. Thus, if the Chinese government didn’t warn the WHO about the outbreak before it heard about it on its own, it’s obviously not because it was trying to keep it secret, since the local health authorities had already made a statement about it and the Chinese press was already discussing it openly.
In fact, according to Hua Sheng, a Chinese economist who wrote a blog post in defense of Gao Fu, the Director of the Chinese CDC, the latter only heard about the outbreak in the evening of December 30, because he saw the chatter that erupted on Chinese social media after Li Wenliang and Xie Linka told their friends about the test results they had seen on WeChat. He then called the Wuhan CDC, which confirmed the story to him. Apparently, the local health authorities had not used the reporting system created after the SARS epidemic in 2003, even though the number of cases of pneumonia of unknown etiology had already exceeded the threshold past which it’s mandatory to report them, which is why the national health authorities did not hear about the cluster until then. Upon learning that, Fu called the National Health Commission, which sent a team to Wuhan on December 31 to learn more. It’s impossible to know for sure whether this story is true, the national health authorities could be trying to protect themselves from criticism by throwing the local health authorities under the bus, but it’s certainly plausible since everybody seems to agree that nobody was sent to Wuhan by the National Health Commission until December 31. If it’s true, it means that the national health authorities learned about the outbreak at the same time as the WHO, so it’s not surprising that they didn’t warn it before. It’s likely that, had the WHO somehow not already heard by then, the Chinese government would have informed it — as it’s required to by international law — as soon as the team sent to Wuhan by the National Health Commission had reported back to it, since the news was already everywhere in the media and there would have been no point in not doing so.
In addition to the test results from 2 different genomics companies that I already mentioned, Caixin also reports that industry leader BGI received a sample on 26 December 2019 and that by 29 December 2019 it had completed sequencing the genome of a new coronavirus that was similar to SARS-CoV-1. It received a second and third samples on December 29 and 30, which upon analysis were also found to contain the new coronavirus. Still according to Caixin, on 1 January 2020, BGI informed the Wuhan Municipal Health Commission and the Chinese CDC of that discovery. The same day, the genomics companies that had received Hubei’s health commission to stop testing and destroy all samples. On January 3, the National Health Commission issued a similar order, informing genomics companies that samples from patients with pneumonia in Wuhan should now be treated as highly pathogenic microorganisms and sent to authorized laboratories or destroyed. This story is now presented by everyone as evidence of a cover-up, including by Mike Pompeo (who in addition to this also claimed that China knew about human-to-human transmission but didn’t say anything “for a month”, which as we shall see is also nonsense), but I think it’s a total misinterpretation of the evidence.
First, according to the people who draw that conclusion from this story, the Chinese government ordered the destruction of the samples that several private companies had analyzed because it wanted to hide the existence of the virus, but this doesn’t make any sense. Indeed, on the same day the National Health Commission ordered private companies to destroy the samples they had, the genome of SARS-CoV-2 was sequenced at the National Institute of Viral Disease Control and Prevention, which as we have seen eventually led to the announcement on 9 January 2020 that a new coronavirus was responsible for the outbreak of pneumonia in Wuhan. In fact, if the National Health Commission started taking steps to assert control on 3 January 2020, it’s probably because it’s the date on which it was able to independently verify that a new coronavirus closely related to SARS-CoV-1 had appeared in Wuhan. I don’t see how destroying the samples in the possession of private genomics companies, which had already been analyzed by this date, could have helped to hide the existence of the virus. It’s not as if the National Health Commission had ordered those companies to wipe their hard drives clean and, in fact, it’s very clear that the data didn’t disappear since, as Caixin notes, the genomes in question ended up on GISAID, a public database. So what exactly do people think China achieved by destroying the samples? This whole theory makes no sense.
If you read the Caixin story closely, a far more natural interpretation suggests itself. According to Caixin, when the National Health Commission ordered private companies to destroy the samples they still had, it did so by invoking the Disease Prevention and Treatment Law. It’s hard to find a lot of information on that law, but from a close reading of Caixin story and what the Director of the Chinese CDC explained during a forum organized by National Science Review in 2016, I gather that it provides that, once a pathogen has been classified in a certain way, only certain laboratories are allowed to analyze samples for safety reasons. In fact, this is exactly what a Chinese official explained during a press briefing in May, after he was asked about it. As the Wall Street Journal admitted, many other governments, including the United States, “have regulations that require labs with lower biosafety ratings to destroy or transfer samples of particularly dangerous pathogens”. Even if there were no law saying that, in the context when this happened, this decision made perfect sense. At the time, the authorities didn’t know anything about the virus except that it had probably caused pneumonia in several people and that it was closely related to SARS-CoV-1, a virus that killed approximately 10% of the people it infected in 2002-2004. The last thing they needed was for another outbreak to start elsewhere because someone working for a private company that had samples was accidentally infected. In fact, according to Caixin, Vision Medicals immediately destroyed the samples without being prompted to do it by anyone after it sequenced the genome of the virus on 27 December 2019 and realized it was very similar to SARS-CoV-1, precisely because it was deemed very dangerous. Private genomics companies that perform diagnostic tests for hospitals are not equipped to deal with new, potentially very dangerous viruses.
Another even that many people seem to think is evidence of some kind of conspiracy is what happened to the laboratory where researchers published the first genome of SARS-CoV-2. As we have seen, after several private genomic companies sequenced the virus, it was isolated and sequenced on January 3 at the National Institute of Viral Disease Control and Prevention. In fact, according to a notice published on the Wuhan Institute of Virology’s website, Shi Zhengli’s team had already managed to sequence the full genome the day before. Moreover, according to a state media interview, another team at the Chinese Academy of Medical Sciences also sequenced it on January 5. The discovery was not publicly announced until January 9, but as I argued above, there is nothing suspicious about that since full-genome sequencing was not enough to identify the virus as the cause of the outbreak of pneumonia in Wuhan. As Caixin revealed in February, in addition to the samples that were sent to private genomic companies in December, another sample from a patient at Wuhan Central Hospital had been sent to a team led by Zhang Yongzhen, a virologist at the Chinese CDC who also works at Fudan University in Shanghai, where the virus was also sequenced on January 5. He uploaded the genome on GenBank, a public database managed by the National Center for Biotechnology Information in the United States, where apparently it just sat under review for a while. However, since the Chinese health authorities had still not published the genome of the virus even after they announced its discovery and he’d already submitted it to GenBank, he decided to post it on virological.org, a forum where virologists discuss recent work in their field, on January 11. According to the Associated Press, which claims to have talked to 3 people familiar with the matter, this move angered Chinese CDC officials.
The day after that, Zhang’s laboratory was ordered to close by the Chinese health authorities, who have so far refused to explain this decision. Many people now claim this event proves that China was engaged in some kind of conspiracy. But what is the conspiracy supposed to be exactly and what purpose was it suppose to serve? The Chinese health authorities had already revealed the existence of the virus, so they were obviously not going to be able to keep the sequence to themselves forever. Beside, I don’t see what the point would have been, again everyone already knew that a new coronavirus related to SARS-CoV-1 had been discovered and was responsible for the oubreak of pneumonia in Wuhan. The only reason I can think of is that researchers at the Chinese CDC wanted to keep the data to themselves for as long as they could, so as to be the first to publish on the virus and get all the credit. In fact, according to Li Yize, a virologist working on coronaviruses at the University of Pennsylvania consulted by the Associated Press, this is probably the reason. The Associated Press also talked to 6 people familiar with the system, who explained that the Chinese CDC “has long promoted staff based on how many papers they can publish in prestigious journals, making scientists reluctant to share data”.
Now, this is definitely bad and I’m certainly not trying to defend it, because the WHO and other countries needed the genome to develop tests for the virus in the event that it spread outside China (which in fact it already had by then), but I don’t see in what sense it was a “cover-up”. It’s just the kind of petty competition that is unfortunately very common in science. By going ahead and publishing the genome without informing the Chinese health authorities, Zhang deprived researchers at the Chinese CDC of the advantage they had on other scientists who didn’t have the data and forced the other labs that had also sequenced the virus to rush and publish their sequences, which all 3 of them did on January 12. According to the Associated Press, however, they only did so after sending everything to the National Health Commission for approval. The Chinese health authorities probably closed Zhang’s lab to punish him for not going through them first before publishing the genome and make sure that other researchers would get the message and respect chain of command before releasing any information on the virus. Obviously, I’m not defending this kind of methods, but it doesn’t show that China was engaged in some kind of conspiracy, especially since again it’s not even clear what it would have achieved. It’s just the way in which the bureaucracy in an authoritarian country keeps people in line.
I think something very similar can be said about the decision by the local authorities to close Huanan Seafood Market and spray disinfectant everywhere on December 31. This was previously believed to have happened on January 1, but according to a very detailed story published in May the Wall Street Journal, professional disinfection crews started spraying the market on December 31. Many people claim that it shows they were trying to destroy the evidence, but a far more plausible interpretation is that they panicked and tried to prevent further infections. Indeed, as we have seen above, everyone at the time, including the “whistle-blowers” everyone is talking about, thought that people had been infected at the market, so this is just the kind of response you would expect from people who suddenly realized a very lethal virus might be spreading over there. Moreover, although the authorities decontaminated the market immediately, samples were still collected. However, the Chinese health authorities have given almost no details on the samples and the results of the tests they performed on them, even though the market was closed more than 6 months ago. At the end of January, state media reported that SARS-CoV-2 had been detected in 33 out of 585 environmental samples taken at the market, 31 of which in the area where stalls of vendors selling wildlife animals were concentrated. On February 9, five genetic sequences found in environmental samples collected at the market were uploaded on GISAID (with accession IDs EPI_ISL_408511 to EPI_ISL_408515), three of which are partial. However, the Chinese health authorities stopped communicating on the matter after that and refused to answer questions about it, at least until the end of May.
No sequences found in samples collected on animals were ever submitted and the Chinese health authorities would not even say whether any samples were taken on animals. They didn’t make any public statement about samples collected on animals until May 25, when the Director the Chinese CDC declared that no virus had been detected in any of the samples taken on animals in the market. According to the Wall Street Journal, Chinese officials had already said that no animal tested positive on January 31, during a meeting of the World Organization for Animal Health. However, according to Ian Lipkin, a virologist at Columbia University who visited Wuhan at the end of January and spoke to the Wall Street Journal in May, the Chinese health authorities were not able to determine which animals they likely came from. Of course, that’s assuming the traces of the virus found in environmental samples taken at the market came from animals and not from humans, which is hardly obvious. (As we shall see later, there is evidence the virus didn’t originate from the market, so it actually wouldn’t be surprising if no animals in the market had been infected.) Moreover, if samples were collected on animals in the market and none of them were positive, it’s weird that Chinese officials waited so long to publicly explain that and refused to answer questions about it for months.
Based on the investigation published by the Wall Street Journal, my impression is that in general the collection of samples at the market was done poorly. Indeed, it seems that samples were collected in a hurry, as disinfection crews were spraying disinfectant in the market and perhaps even after that. (According to the information on GISAID for the sequences uploaded on February 9, the environmental samples were collected on January 1, after the decontamination of the market had already started, although I wouldn’t put too much stock in that since I’m not sure how carefully researchers fill out that information.) It’s very difficult to figure out what happened, because Chinese officials give almost no details and different researchers have heard different things, but I suspect that, upon realizing that none of the samples collected on animals were positive, the Chinese health authorities would have liked to take more samples and check again to make sure no animals was infected, but it was too late because the market had already been decontaminated and the animals destroyed. Back in February, Caixin had already published a story, where Lipkin was also quoted, that suggested the market had been decontaminated before enough samples could be collected.
This could explain why Chinese officials have been so reluctant to share details about the samples collected in Huanan Seafood Market, namely because they had screwed up and didn’t want to admit it. However, I suspect another reason is that, back in February, the Chinese propaganda started peddling the theory that SARS-CoV-2 may not have originated from China, so Chinese officials didn’t want to talk about the origins of the pandemic and how it started in Wuhan. In any case, I don’t understand what the people who say it’s evidence of a conspiracy think the Chinese government had to gain by decontaminating the market before enough samples could be collected, it doesn’t make any sense to me. Having more samples from Huanan Seafood Market would either have supported the hypothesis that SARS-CoV-2 originated from there or shown that, as now seems more likely (I will come back to this later), it came from somewhere else, but in either case I don’t see what it would have changed for the Chinese government. As I already noted, the decision to decontaminate the market right away instead of waiting for scientists to collect more samples is easy to explain by a combination of incompetence on the part of the local health authorities and the fear of a public health disaster, which is exactly how such a screw-up would have been interpreted if it had happened in a Western country.
In general, to the extent that Chinese officials didn’t handle the crisis well at the beginning, it has more to do with administrative red tape and bureaucratic incompetence, which believe it or not also exist in China, than a conspiracy to hide the discovery of SARS-CoV-2. The people who claim that the Chinese government knew exactly what was going on and tried to cover it up are talking about this as if Chinese officials knew then what we know now about the virus. But everything indicates that even the local health authorities didn’t even realize there was an outbreak of viral pneumonia in Wuhan, let alone that it had been caused by a new virus, until sometime between December 28 and December 30. At least one bureaucrat working for the Wuhan Municipal Health Commission probably heard that Vision Medicals had found a new coronavirus in a sample collected on a patient with pneumonia at Wuhan Central Hospital on December 27, but it doesn’t mean they immediately realized the significance of that discovery. Of course, now that we know everything that happened after that, it seems obvious that it should have alarmed them, but at the time it must not have been so obvious. According to Caixin, even the people at BGI didn’t think much of it when they first sequenced of the genome of SARS-CoV-2. As one of their employees told Caixin, they come in contact with a large number of viruses, including new viruses, all the time as part of their work. So when they discovered a new coronavirus in the sample they had received from Wuhan, they “did not know whether it was ‘good’ or ‘bad'”.
Now, it’s true that BGI’s employees apparently didn’t know that several people had possibly been infected by this virus in Wuhan and were suffering from pneumonia, but it’s hardly obvious that whoever at the Wuhan Municipal Health Commission was informed that Vision Medicals had discovered a new coronavirus that was very similar to SARS-CoV-1 in a sample taken on a patient at Wuhan Central Hospital — assuming someone was — knew that either. Again, even if we accept everything that Caixin reports (including the claims that come from social media posts), on December 27, the local health authorities didn’t really know yet that unusual cases of pneumonia had started to accumulate in Wuhan hospitals, so it’s not that surprising that, if someone at the Wuhan Municipal Health Commission was informed of the discovery, they didn’t think much of it. On the other hand, by the time BGI and the Beijing-based company also sequenced the virus and sent back the results (which happened a few days after Vision Medicals called Zhao Su), the local health authorities had realized there was a cluster of pneumonia cases in Wuhan, but this is precisely when they started taking steps to deal with the problem and it’s also when the process that eventually led to the identification of SARS-CoV-2 at the National Institute of Viral Disease Control and Prevention was initiated.
Of course, I’m not saying they shouldn’t have investigated this sooner and that it wasn’t a professional fault not to look into this immediately after Zhao Su heard back from Vision Medicals, but this is just run-of-the-mill bureaucratic incompetence, not smoking-gun evidence of a cover-up. It’s also not something that is unique to China or authoritarian countries. The way in which other countries, including and perhaps especially Western democracies, have dealt with the pandemic offers countless examples of far worse bureaucratic incompetence. The problem is that, because people don’t like China’s regime, they end up reasoning as if the kind of bureaucratic incompetence that we see all the time in the West didn’t also exist in China, so they automatically go for the conspiratorial interpretation. (To be clear, although I find this interpretation totally implausible in this case, I’m using the word “conspiratorial” in a neutral way here. Conspiracies definitely happen all the time, so there is nothing wrong with proposing that kind of interpretation per se, I just don’t think it’s supported by the evidence in this case.) But that’s obviously not the case and, once you remove this hidden assumption, the depressing but less nefarious interpretation I’m proposing becomes far more plausible.
For instance, in France, where testing capacity has been a huge problem since the beginning of the crisis, public veterinary laboratories had to beg the government for almost 3 weeks before they were allowed to perform tests, which they are perfectly capable of doing but couldn’t because of a stupid regulation that could have been revoked in a matter of hours. However, this isn’t because the French government was engaged in a conspiracy to increase the profits of private laboratories by making sure they would do most of the tests or whatever, it’s just because many French bureaucrats are totally incompetent. But we’re supposed to conclude that the Chinese government was definitely engaged in a vast conspiracy to hide the discovery of a new coronavirus that was responsible for the outbreak of pneumonia in Wuhan because it took the local health authorities 3 days after the virus was first sequenced to start acting on this information? This isn’t serious. I think that, if everything had gone fine, it’s plausible that the identification of SARS-CoV-2 as the cause of the outbreak of pneumonia would have been completed and announced to the world a few days, perhaps as much as a week, sooner. But that’s probably not because the Chinese government was engaged in a conspiracy to cover it up. The truth is that, despite a few mistakes at the end of December, the identification of SARS-CoV-2 as the cause of the outbreak was remarkably fast.
It could probably have been identified even faster if the cluster of pneumonia itself had been noticed sooner. According to the New York Times, which relied on Chinese media reports and interviews with former officials, the system created after the SARS epidemic in 2002/2004 to detect outbreaks of infectious diseases didn’t work as planned. Every suspicious case was supposed to be immediately reported to the national health authorities in Beijing, where people trained to detect contagious outbreaks and take steps to suppress them before they spread. This system was created precisely to prevent the kind of political interference that had kept Beijing in the dark and delayed the response at the beginning of the first SARS outbreak in 2002, but according to the New York Times, it didn’t work because the local health authorities insisted on keeping control on what was reported to Beijing instead of letting doctors report the information as they were supposed to and the national health authorities only realized there was a cluster of unusual pneumonia in Wuhan on December 30, after the leaks on social media started the rumor that several people with SARS were hospitalized in Wuhan.
As I already noted, this narrative is certainly not implausible. It wouldn’t be the first time that Beijing is kept in the dark by local authorities. But there doesn’t seem to be much in the way of evidence to support this story. It’s also possible that the national health authorities did receive at least some of the information before December 30, but didn’t act on it and are now trying to cover their asses by rejecting the blame on the local health authorities. As I already noted, bureaucratic inertia and incompetence is not something that only exists in the West, there is plenty of that in China and not just among local officials, even though party officials in Beijing frequently use them as scapegoats for their own corruption or for mistakes they knew about and sometimes even benefited from. It’s not just the national health authorities who could be trying to cover their asses by throwing the local health authorities under the bus, I also suspect that part of the story here is that doctors are trying to do the same, because they should have reported some of the cases earlier but didn’t follow protocol. The New York Times suggests they didn’t report the pneumonia cases in the system because they didn’t know what category to classify them under, but as the article also notes “pneumonia of unknown etiology” would have done. Just as there is no reason to assume that only the local health authorities can be incompetent and not the national health authorities, there is also no reason that doctors in Wuhan are incapable of screwing up. It’s not true of doctors anywhere else, so I don’t see why it would be true of doctors in Wuhan. I don’t think we’ll ever know exactly what happened and who did what, but in any case, there is no evidence that any conspiracy to cover up the outbreak actually happened, it was just bureaucratic inertia and incompetence.