COVID-19

COVID-19, the WHO, and China

There have been a plethora of misleading and poorly researched news articles published lately, usually followed by a flood of ignorant, verging on the hysterical, social media commentary, on the subjects of the SARS-CoV-2 (which stands for Severe Acute Respiratory Syndrome CoronaVirus 2, because the virus is a genetic cousin of the Severe Acute Respiratory Syndrome CoronaVirus, SARS-CoV, which caused the SARS outbreak in 2002), the disease it causes (COVID-19, short for Coronavirus Disease of 2019), and the role of the World Health Organisation (WHO) in recent global events.

Consequently, I have been doing a lot of research on the subject matter and engaging in social media conversations trying to correct some of the misinformation circulating, and inject factual information into the increasingly rankerous online debate, with varying degrees of success.

The WHO
The beginning – 2019
The conspiracy theories
Taiwan’s controversial role
The events of 2020
The ‘travel ban’ controversy
Wet markets
China’s attitude a collective international responsibility

There are no easy answers to the complex questions raised by the current pandemic, whether in respect of the virus itself, China’s role, or the WHO’s response, so those who are looking for easy answers, or scapegoating the WHO, will be disappointed.

The WHO

The WHO is an agency of the United Nations, responsible for international public health, and it delivers incredible work worldwide.

It is a global bureaucracy, which operates in a geopolitical minefield with no coercive powers, and relies on persuasion and cooperation, so it is a miracle it operates as efficiently as it does.

The WHO is dependant on the voluntary support and monetary contributions of its members nations, and donors, to accomplish anything. It has no independent funding, or authority over any territory, so it cannot go anywhere uninvited. The expertise and coordination it offers is usually borrowed from charities and member nations, and its role is largely limited to international coordination.

For example, during an emerging pandemic, the WHO largely uses medical and epidemiological data voluntarily provided by relevant member countries, because the WHO has no coercive powers, cannot compel cooperation, and its teams can only collect data on location when permitted by the host nation, and then only to the extent it is permitted to do so.

That’s how member nations set up the WHO, but now the organisation is being criticised for those very fundamental flaws in its ability to operate independently and more authoritatively.

Arguably, the events of 2020 so far have become a prime demonstration of why we need to strengthen our global institutions, such as the WHO, so they have independent funding and tangible powers to intervene and investigate, and don’t have to rely on information voluntarily provided by member states or a host nation’s permissions to investigate.

However, if instead, Donald Trump, China, and even the Australian Government are permitted, even encouraged, to politicise a pandemic and use the WHO to have a go at each other, or as a diversion from arguably glaring personal incompetencies in the case of Mr Trump, or from catastrophic institutional failures and coverups in the case of China, in the middle of a pandemic, we all lose.

It is unfathomably irresponsible for certain politicians and media organisations to engage in a verging on the hysterical, ill-timed, and very distracting campaign against the WHO in the midst of a global pandemic.

Of course, like any bureaucracy, the WHO is also ripe for some organisational reforms going forward, but that should wait until the world gets the upper hand on the COVID-19 pandemic, which arguably should not have been a huge surprise to nations given the repeated warnings of such an event over the better part of the past two decades, and some recent scares, from Ebola to SARS, MERS, and the swine flu.

Is the WHO perfect? Of course not.

Have they made mistakes? Of course, but let’s not overlook that it is an international body operating on a consensus basis, so any failings of the WHO are arguably a collective international failing.

Can all the problems with the COVID-19 response blamed on the WHO? Absolutely not.

One only needs to observe the limited spread of COVID-19 so far in nations such as Australia, New Zealand, or Greece, to see the critical difference between nations with complacent governments and arguably highly incompetent responses to the emerging pandemic, vis-à-vis governments that took responsibility, and timely and decisive action.

Further, some of the countries hardest hit by the COVID-19 pandemic have a track record of senior government officials systematically denying the severity and dangers of the growing pandemic despite the emerging reality of the situation, and a lack of sensible, evidence-based planning, such as the highly questionable initial concept of building up ‘herd immunity’ in the UK by permitting the virus to spread, that resulted in early failures to prepare, ill-considered decisions along the way, and catastrophic long-term consequences, but catastrophic consequences entirely of their own makings.

The beginning – 2019

What we know so far is that on 10 December 2019, Wei Guixian, a seafood merchant at Wuhan’s Huanan market, started to feel sick and presented herself at a local health clinic, later becoming one of the first known SARS-CoV-2 infections in China.

She is widely considered to be ‘patient zero’, although in epidemiology ‘patient zero’ can be a very difficult matter to establish, and rarely is there absolute certainty.

She was admitted at Wuhan Union Hospital on 16 December. A doctor there described her illness as ‘ruthless’ and told her several other people from the same market had already come in with similar symptoms, she later recounted in an interview with Chinese news outlet The Paper.

On 16 December a patient was admitted at Wuhan Central Hospital with an infection in both lungs resistant to drugs. Staff later learned he also worked at Wuhan’s Huanan market.

On 27 December, Wuhan health officials were reportedly informed by local laboratory executives that a new coronavirus is causing the illness being observed at their health facilities.

On 30 December, Ai Fen, a top director at Wuhan Central Hospital, posted information to WeChat about the new virus. She was promptly reprimanded for doing so, and was told not to spread information about the matter.

The same day Wuhan doctor Li Wenliang, also from the Wuhan Central Hospital, now deceased from the virus, also shared information on WeChat about a new SARS-like virus. He was called in by police for questioning shortly afterward, and received a warning.

On 31 December Wuhan health officials confirmed 27 cases of the illness and closed the market they thought was related to the virus’ spread. On the same date China formally reported to the WHO a cluster of pneumonia cases in Wuhan, Hubei Province.

Yet, on 1 January 2020 the Wuhan Public Security Bureau was reported of still bringing in eight doctors for questioning over posting information about the illness on WeChat.

It has been suggested that local party officials in Wuhan were particularly sensitive and secretive about the emerging contagion because the city was slated to host meetings of local and provincial leaders from 6 to 17 January, and they were concerned about jeopardising the meetings going ahead, motivating them to hide these ‘undesirable developments’ from Beijing.

Meanwhile Chinese citizens were travelling abroad, arguably spreading the virus globally, and foreigners visiting China were returning home with the illness, completely oblivious to the dangers.

In this context China has a lot of questions to answer over the initial cover-up and the delays in taking serious steps to contain the virus internationally.

The conspiracy theories

Preposterous conspiracy theories have propagated almost immediately, faster than social media operators could keep up.

For example, there are suggestions the virus was manufactured at the Wuhan Institute of Virology. At first glance, this is entirely inconsistent with what we already know about the connection of the virus with the Wuhan Huanan market.

At second glance, numerous reputable, independent scientific teams analysed the genome of the virus, including in Australia, and none of them suggested or reported any suspicion that the virus is anything else but a natural jump of an infection from animals to humans, as it happened countless times before in human history because of our own carelessness and lack of respect for our natural environment, with no credible evidence whatsoever of the virus being ‘manufactured’.

This conspiracy theory was given new life when fringe websites reported on comments made by French Nobel Prize winning HIV scientist Professor Luc Montagnier during an interview to the French CNews channel and a Pourquoi Docteur (‘Why Doctor’) podcast, suggesting that the virus came from a lab, and it is likely the result of trying to create a vaccine against HIV, claiming that the genome of the virus is highly suspect.

Unfortunately, as far as we know, Professor Montagnier has not examined the virus in a laboratory setting, and he has not published a scientific paper detailing his findings so it could be subjected to peer review. Consequently, until he does so, no matter how eminent and respected he may be in his field, his ‘personal views’ are just part of the unsubstantiated rumour-mill.

It is notable that Professor Montagnier has been criticised in recent years over his support for pseudoscientific homeopathy, and anti-vaccination views. Fellow scientists have responded to his latest comments by noting that worldwide genetic mappings of the virus had shown that it has a natural origin, and was not engineered, and the so-called ‘unique’ protein sequence insertions found in the virus Professor Montagnier referred to in his comments, can in fact be found in many other organisms, not just HIV.

A variant of the theory to the Wuhan Institute of Virology, which has become a darling of the more mainstream conservative media, accepts the virus naturally, but posits it was isolated by scientists at the lab, and released through human error.

There are also suggestions that the first documented case of someone in China suffering from COVID-19 may have occurred as early as 17 November, but there has been no sufficient evidence presented in support of that allegation to date.

In any event, initial tests would have taken many days, if not weeks, to work out the nature of the illness, like with all new, previously unknown pathogens.

Also, it would be typical for China, a totalitarian regime, to first attempt to cover up matters that threaten civil order, as a matter of course. And it is clear they have done so in this case but, sadly, that’s just ‘standard’ communist China.
Another ludicrous conspiracy theory attempts to link the virus to the roll out of the 5G network.

Yet another theory was attempting to accuse US troops of importing the disease to Wuhan during the Military World Games, although this theory is easily destroyed by applying literally 5 seconds of logic … That’s because we know that the incubation period of COVID-19 is around 14 days at the most, often less.

Consequently, if the source of the outbreak was US soldiers at the Games, the outbreak would have enveloped the world far sooner than March/April this year, presuming the infection was spread by soldiers returning to their respective home countries at the end of October and first week of November. The pandemic would have enveloped the entire world much sooner, and the initial hot spots would have been concentrated around military bases.

One of the more recent conspiracy theories puts Bill Gates, philanthropist and Microsoft founder, at the heart of the pandemic, citing his TED talk above and his US$250 million contribution pledged towards developing an effective vaccine.

There are various permutations of this conspiracy theory with some claiming only that Bill Gates had prior knowledge of the COVID-19 pandemic (apparently, evil billionaire geniuses have regular meetings where they discuss how they are going to cull the human population – I blame Hollywood and the James Bond franchise for this), while others accuse him of actually creating the virus in the first place to profit from the fallout, including by providing a vaccine at some later point which would apparently contain some sort of ‘digital marker’ microchip to enable governments to track people.

Conspiracy theorists may have been considered amusingly harmless, eccentric misfits once, but now they are becoming a downright threat to public health and safety, and society as a whole.

We need to start exploring specific and targeted law enforcement options in respect of people who engage in this kind of mischief, whether ignorantly or maliciously, to address that very real threat.

And yes, of course they can continue to enjoy their right to free speech, but like any other right, the right to free speech comes with corresponding responsibilities both legal and social and, when those responsibilities are breached, consequences. And, demanding rights while skirting the corresponding responsibilities is not ‘freedom’ or ‘democracy’ … it’s just adolescent and selfish, with a considerable dose of ignorance.

And when conspiracy theorists cross the line into committing real world violence or damage to property, such actions shouldn’t be considered anything less than domestic terrorism and punished as such, especially when they involve critical communications networks.

Taiwan’s controversial role

Taiwan played a controversial role in the COVID-19 saga after it claimed to have advised the WHO of the outbreak, and that the WHO ignored its warning.

This was reported as gospel truth by a number of news outlets, and online this news story soon morphed into an assertion that Taiwan had alerted the WHO that human to human transmission of the virus was a proven fact, but the WHO ignored it.

The reality is that on 31 December, the same day China contacted the WHO, Taiwan sent a brief email to the WHO in which Taiwan referred to ‘news resources’ indicating ‘seven atypical pneumonia cases’ in Wuhan and noted that samples were ‘still under examination’. There was no reference to human to human transmission in the email.

The email must also be considered in the context of the complicated China-Taiwan relationship, which is highly contentious.

The other controversy has been that Taiwan is not a member of the WHO. Sadly, this is true but, frankly, it is not the WHO’s fault. Most nations around the world refuse to recognise Taiwan as an independent nation and it is not a member of the United Nations, nor its various bodies, such a the WHO, due to international acquiescence with the one China policy.

Even the Australian Government does not recognise the Republic of China, known as Taiwan, as a sovereign state and does not regard the authorities in Taiwan as having the status of a national government.

Dealings between Australian government officials and Taiwan take place only unofficially, because Australia also abides by the one China policy, and only recognises the Government of the People’s Republic of China as China’s sole legal government.

The events of 2020

After receiving its first alert from China on 31 December, the WHO analysed the information it received, and it alerted the world to the existence of the new illness on 4-5 January.

On 9-10 January the WHO issued an online package containing technical guidance, with advice to all countries on how to detect, test and manage potential cases, based on what was known about the virus at the time.

On 12 January the WHO announced that China shared its genetic sequencing of the new virus, meanwhile nations around the world were working on their own sequencing, including in Australia.

On 14 January the WHO sent out a now highly controversial tweet which was later arguably maliciously misinterpreted and taken out of context, partly due to the media misreporting it, and partly due to partisan politics.

This much maligned tweet talks about ‘no clear evidence of human-to human transmission’ of the virus, however it clearly does not deny the possibility of such transmission, just highlights that at that stage the information the WHO has been provided by China indicated no clear evidence of such transmission.

In fact, later the same day, WHO’s technical lead for the response expressly noted in a press briefing that there may have been limited human to human transmission of the coronavirus (in the 41 confirmed cases at that stage), mainly through family members, and also that there was a risk of a possible wider outbreak.

The lead also noted at that time that human to human transmission would not be surprising given the experience with SARS, MERS and other respiratory pathogens, but more work was needed to establish to exact mode of transmissions.

Let’s face it this has been a fast evolving global situation, with world leaders and medical experts, even our own Prime Minister and Chief Medical Officer, confusingly saying widely different things from hour-to-hour when this pandemic started, given new facts and information were becoming available constantly, and changing the relevant information sometimes from one hour to the next.

On 21 January a WHO delegation was permitted to conduct a field visit to Wuhan, China.

A day after the field visit, on 22 January the WHO mission to China issued a statement saying that there was evidence of human to human transmission in Wuhan but more investigation was needed to understand the full extent of transmission.

On 22-23 January the WHO’s Director-General convened an Emergency Committee meeting under the International Health Regulations to assess whether the outbreak constituted a public health emergency of international concern. Present at that meeting were members from around the world, including the US, Thailand, Russia, France, South Korea, Canada, Japan, Netherlands, Australia, Senegal, Singapore, Saudi Arabia, Sweden, and New Zealand.

Later this meeting was reported as the WHO having refused to make a public health emergency declaration. In my opinion that’s a gross misrepresentation of what had happened, because at that meeting a vote was taken from the members present, including the US, Australia, New Zealand, France, Canada, and South Korea, and those at the meeting didn’t agree to declare a public health emergency. The advice presented and the vote is confidential, but for the vote to have been split and lost, several Western, or Western-aligned, representatives must have backed China’s position, which argued against declaring a global emergency.

The members asked to be reconvened within 10 days after receiving more information.

The WHO Director-General decided to reconvene the Emergency Committee meeting prior to the expiry of that 10-day period on 30 January 2020. At that meeting a public health emergency declaration was finally agreed to by the members.

On 3 February the WHO released the international community’s Strategic Preparedness and Response Plan and continued to lobby for nations around the world to take the virus seriously, and prepare for it.

The WHO also maintains a rolling update of its COVID-19 responses.

In this context it is also relevant to note that in the course of the Trump administration the presence of the US Centers for Disease Control and Prevention (CDC) in China had shrunk to around 14 staffers, down from approximately 47, due to cost cutting measures, including epidemiologists and other health professionals.

It has also been reported that over a dozen United States physicians and public health experts, many of them from the CDC, are embedded at the Geneva headquarters of the WHO, and they were passing on real-time information about events unfolding in China to the Trump administration from December 2019 onwards.

The ‘travel ban’ controversy

As for the travel ban controversy, in my opinion it is both simplistic and loaded to assert they were put in place by countries ‘against the advice of the WHO’.

Unsurprisingly, the WHO has a pandemic response plan based on the best available science, including epidemiological and medical markers and triggers for certain actions and responses, developed in consultation with its member nations.

If the relevant epidemiological and medical marker and trigger is not present for a particular action and response, the WHO is unable to advise for such an action and response.

The WHO also expressly stated at the time that it can only support ‘decisions that are evidence-based and consistent’. That’s a very standard scientific approach for an organisation involved in health and medicine.

However, political decisions can be made, as our Prime Minister did, on far lesser evidentiary basis, and that’s exactly what had happened here. And yes, Australia moved fast thankfully, but arguably that was just a fortuitous combination of luck and politics, with a Prime Minister likely looking for an opportunity to reestablish his leadership credentials and redeem himself after the summer’s bushfire fiascos.

In any event, the WHO has been making largely the same observations about travel bans that many conservative commentators, end even Donald Trump, are making about our current restrictions, in that ‘restrictions may interrupt needed aid and technical support, may disrupt businesses, and may have negative social and economic effects on the affected countries.’ And indeed they are.

The WHO also advised that ‘such restrictions must be based on a careful risk assessment, be proportionate to the public health risk, be short in duration, and be reconsidered regularly as the situation evolves.’ And they are, and will continue to be.

Australia also largely followed the advice of the WHO when it comes to repatriation procedures: ‘exit screening shortly before flight; risk communication to travellers and crew; infection control supplies for voyage; crew preparedness for possibility of sick passenger in flight; entry screening on arrival and close follow-up for 14 days after arrival’, noting that ‘[s]ome countries may require returning travellers to enter quarantine.’

Unfortunately, or fortunately, we will never know how effective our travel ban really was, but we know for sure that we spectacularly mismanaged the Ruby Princess embarkation process which gave rise to one of the biggest infection clusters in Australia.

Wet markets

There has been a lot of hysteria around so-called ‘wet markets’ as well, and the WHO’s approach to such markets.

The basis of any discussion about ‘wet markets’ must be the understanding that ‘wet market’ is a generic term across Asia for farmers markets, markets where butchers and grocers sell fresh produce straight from the farm, from beef to pork, poultry, and seafood (a lot of which is actually imported from Australia).

They are called ‘wet markets’ generally, because the floors are often hosed down after vendors wash their vegetables or clean their meat or seafood. Effectively the Sydney Fish Market is a ‘wet market’ …

These markets are just places to go to buy fresh food, such as chicken, pork, beef, seafood, and vegetables, at affordable prices by a large proportion of people across Asia, and similar markets exist across the world. These markets are not potential virus petri-dishes filled with exotic, wild animals ready to be slaughtered, and can be operated safely and regulated by implementing basic health regulations, like everywhere else in the world.

However, a subset of these ‘wet markets’ trades in exotic, wild animals and can be found across Indonesia, Malaysia, Philippines, Singapore, Taiwan, Thailand, and Vietnam, and yes, they are problematic.

In summary, the issue is not ‘wet markets’, but ‘specialist wet markets’ that trade in exotic, wild animals.

So when the WHO supports ‘wet markets’ it simply supports farmers markets, while it is calling for the closure of ‘specialist wet markets’ that trade in exotic, wild species. This is a consistent and logical position that accords with what we have learned from epidemiology.

The director of the World Health Organization also confirmed personally that wet markets should only be reopened on the condition that they conform to stringent food safety and hygiene standards.

China’s attitude a collective international responsibility

As for China’s smug attitude towards international demands that it take responsibility for its initial delays and suspected cover up, and issuing threats instead, it is arguably a direct result of a colossal, collective, international hypocrisy, decades in the making. Sadly, we largely enabled this type of behaviour by:

  • our collective, decades long international appeasement of China’s totalitarian regime in respect of Taiwan and Hong Kong, under their so-called one China policy; and
  • without going into any detail about the well-known tragedies of Tibet or the Uighur people, topics that barely skim the surface of China’s appalling track record, happily doing business with, and thus financing, this human rights abusing totalitarian bully purely for economic reasons, discarding moral considerations entirely, in order to keep selling our minerals, and keep our stores filled with cheap consumer goods.

As for the people expressing faux outrage over the WHO not ‘standing up’ to China when it may have become clear that the WHO were not given up-to-date or correct information, or that China did not cooperate fully, I refer them to the quiet international collusion in respect of Taiwan, Tibet, the Uighur people, and our economic dealings with China taking absolute priority over confronting China for their endless human rights abuses and failures.

Knowing how China operates in the real world, it would have been downright foolish for the WHO to antagonise China during an unfolding pandemic, when it needs China to cooperate, and continue to cooperate, voluntarily more than ever.

What would have happened if the WHO antagonised or criticised China’s response or cooperation publicly? We all know what happens to Western journalists in China who are perceived to have slighted the regime.

China’s contemptuous attitude towards dissent was further demonstrated just this week, when under the cover of the COVID-19 global pandemic distraction, China arrested scores of pro-democracy activists, highlighting the immense difficulties with holding the regime to account.

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