China, Trump and COVID-19: What’s the real story?

Now that the Covid-19 pandemic is brutally real, and not just a flu as President Trump described it in mid-March, and with the US reporting the most deaths by far in the world—more than 60,000 as of this writing—more and more people are questioning the response by the Trump administration. Numerous polls indicate that only about 35 percent of the US population think he is truthful in his interminable daily briefings, or that he has handled the crisis effectively.

As the criticisms increased, President Trump and the Republican Party decided to blame China, so it is valuable to examine the reactions to the pandemic from both the China and US sides. 

President Trump began to implicitly blame China for the pandemic very early, when he insisted in calling it the “Chinese” or “Hunan” virus; but he eased up on this, reportedly after a phone call with Chinese president Xi Jinping. About 4 to 5 weeks ago, however, Trump and his Secretary of State Mike Pompeo began to stridently accuse China of direct responsibility for the worldwide spread of the virus, allegedly because they had withheld information when the virus could still have been controlled within China. 

At the same time, Trump accused the World Health Organization (WHO, a United Nations body) of helping to cover up China’s alleged misdeeds, and announced that the US would withhold its contribution to that organization, which amounts to about 15 percent of its budget. This action was taken just when the virus began to show up in Latin America, the Middle East, Africa and parts of Asia, areas still untouched, and where it is projected millions may die. The WHO is without question the most important body in existence that can help those developing and poor countries to combat the pandemic, and the international outcry about this decision has been enormous. 

Initially the accusations were about withholding information. They then escalated to allegations that the virus had escaped from a Chinese virology research laboratory in Hunan. Yet no one from that laboratory has been found to have been infected with the virus. It is located about 9 miles from the “live” meat and fish market in Wuhan considered to be the likely original source of the virus —too far for credible airborne transmission– and is also China’s premiere biological safety lab, which houses the scientists who worked out the gene map of the virus and made it available to the whole world on January 9. Practically the entire world was aghast at the WHO decision, and much of the scientific community has accepted the origin of the virus that the Chinese health authorities have reported.

It is only fair, then, to ask whether the Chinese actions had anything to do with Trump’s failed response: Did the Chinese government do anything wrong, and if so, what, when and what impact did it have? As it turns out, the Chinese authorities did in fact fail to respond adequately in the early stages of the pandemic, but far from enough to cause the US response to fail as catastrophically as it has. 

The following summary captures information reported by the New York Times, the news service AXIOS, the Washington Post and other media sources.

The first cases of a rare and serious pulmonary disease were reported within China in mid to late December of 2019, but their scientists did not yet understand much about it, or found evidence that the virus could be spread from person to person. The first death in China was reported as an “unknown respiratory illness” to the WHO. 

For a short period in January the Chinese authorities failed to provide important information; in particular, they reported to the WHO that there “was no clear evidence of human-to-human transmission” of the virus on January 14, and that there were no new cases, which was not true. Why the apparent delay to convey information to the WHO and the world in those couple of weeks, if in fact the Chinese did so? One can only guess, but it would not be surprising if a culture of secrecy and not sending bad news up to higher levels in China’s political system was at play, along with the typical response of any government to avoid panic. A culture of ‘secret-ism.’ Unacceptable, but also not unusual. 

Another very tragic incident that reflected the culture of ‘secretism’ was the case of Dr. Li Wenliang, a physician who treated some of the earliest Covid-19 patients and later died of the disease. He tried to sound the alarm to his medical colleagues but was reportedly reprimanded and shut down by Wuhan security personnel, along with other doctors who were raising the alarm. Although this was almost certainly a local action, it likely reflects the culture of controlling ‘bad’ information in China. The tragic irony of this case is that only a few days later the national government recognized the courage of Dr. Li, apologized to the family and the country, demoted and severely reprimanded the officials who did it, and named him as a hero in the fight against the pandemic. At least they recognized their mistake, which is more than Mr. Trump has ever done.

During this period of time the Chinese themselves did not yet seem very concerned about the virus, however. They held several widely attended meetings of high officials of the communist party in Hunan, including large public events like a Lunar New Year Banquet on January 18. That changed dramatically on January 23 when Hunan and three other cities were locked down, nearly 60 million people. 

But what did the US administration know during this time, and what did they do about it?

On April 21, the Washington Post reported that in the month of January “Trump Administration officials from the Department of Health and Human Services (HHS), the Centers for Disease Control (CDC) and the National Institutes of Health (NIH) were among those conferring regularly in Beijing with WHO officials ranging from those based in China to…the Director,” and that the US staff embedded within the WHO (more than a dozen) were working full time at the WHO’s Geneva headquarters as the virus spread and “transmitted information in real time to the Trump administration.”  The Post also reported that “the head of CDC’s office in Beijing had at least eight meetings with the WHO in January,” and that Secretary Azar (HHS) met with the Chinese Health Minister that month as well. It is thus false to assert that the US was not well informed about the epidemic bursting in Hunan, regardless of what the Chinese did or failed to do. The Lancet, one of the world’s leading science journals, published a paper on January 30 forecasting a global pandemic and stressing the need for securing enough protective and medical equipment, personnel, and resources to “deal with the consequences of a global outbreak of this magnitude.” 

By mid-January, the US intelligence agencies were already communicating the danger all the way up to the head of the National Security Council in the White House—a position that responds to the President directly.  We also now know that the President’s daily briefing books contained more than a dozen explicit warnings about the developing pandemic in January and February.  This briefing summarizes for the president the most important global security threats. Also, a widespread network of contagious disease and vaccine experts in the US was already and repeatedly communicating the danger of the virus in January to the leaders of all the major US public health agencies—HHS, CDC and NIH. 

Peter Navarro, assistant to the president and director of Trade and Manufacturing Policy, sent the president a memo on January 29 warning of the catastrophic health and economics effects of the brewing pandemic; and Secretary of HHS Azar conveyed the warnings to the president by phone on January 30, reportedly the second time he had done so. Trump took no action. 

The first case of Covid-19 in the US was reported on January 22 (although we now know the first was probably earlier), yet Trump told the nation that “we think it’s going to have a very good ending for us.” Trump took no action.

On January 30, the WHO declared a Global World Emergency, then a Global Pandemic on March 11, as the virus was already reported in more than 100 countries. Both announcements provided clear and dire warnings to all governments about the seriousness of the virus, yet in mid-March, President Trump described Covid-19 as little more than a flu and took no action, except to close the entry to many travelers from China, and also from Europe, when Covid-19 was already raging in Northern Italy. But the cat was way out of the bag already, as many experts consider that the virus in the East Coast almost certainly came from Europe, not directly from China.

By late-January and certainly by March the virus was striking China in full force, and the Chinese had long abandoned their silence and were communicating information transparently about the pandemic to the WHO and to the world. They had clearly learned their lesson and were also implementing widely reported and so-called “draconian” lockdowns in several major cities (the world would soon duplicate much of the same “draconian” shutdowns), as well as many other measures to combat the virus. Still, the world watched as Chinese hospitals began to overflow with desperately sick people. Yet on February 23, Trump reported to the nation that “we have it very much under control in this country,” and the administration took no further action.      

Throughout these critical 6 to 8 weeks, from at least mid-January to mid-March and beyond, very senior US scientists and officials in China, Geneva and the relevant agencies in the US were informed of the brewing pandemic, perhaps starting as early as mid-December, and they communicated these warnings repeatedly to the White House and to President Trump himself. 

In the face of all that information which was available directly and repeatedly to the President, and long after the Chinese had screwed up for 1 to 2 weeks, the only action the Trump Administration took was to limit travel from China and Europe, when the virus was already spreading in the United States. Mr. Trump minimized the pandemic again and again, from calling it just like the flu to claiming that we had it all under control. 

Language cannot do justice to how much was not done in that time, as the spread of Covid-19 grew across the country, and the death count mounted.  The US is supposedly the most powerful country in the world, yet we lead in Covid-19 deaths by a huge margin. No measures were taken to obtain and stock supplies of personal protective equipment (PPE) for health care workers, and the shortage is still severe today, or to make certain we had the supply of the right medical equipment and the intensive care beds needed to treat Covid-19 patients. Tests to measure who is or has been infected, and thus to treat individuals, and measure the scope of infection in the population and ensure as safe a re-opening as possible are still barely available, and the blind reliance on the private sector to provide them is proving to be a failure, with reliable test kits only now appearing on the market, but still in insufficient numbers, and reportedly dozens of others on sale which fail to meet even minimal measure of accuracy. 

Even today health care workers are dying for lack of protective equipment. Still today no national arrangements or resources are available to identify cases and their contacts and isolate them in time to prevent the spread of the virus.  And, yes, we now face what experts tell us is a likely second surge or even more of the Covid-19 plague later this year.

Manuel  R. Gómez, DrPH, MS, CIH has an undergraduate degree from Harvard in Biochemistry, a master’s in Environmental Health from Hunter College, and a doctorate in Public Health from Johns Hopkins.