The Associated Press reports that in the six days after top Chinese officials secretly determined they likely were facing a pandemic from a new coronavirus, the city of Wuhan at the epicenter of the disease hosted a mass banquet for tens of thousands of people; millions began traveling through for Lunar New Year celebrations.
President Xi Jinping warned the public on the seventh day, Jan. 20. But by that time, more than 3,000 people had been infected during almost a week of public silence, according to internal documents obtained by The Associated Press and expert estimates based on retrospective infection data.
Without these internal reports, it took the first case outside China, in Thailand on Jan. 13, to get leaders in Beijing into recognizing the possible pandemic before them. It was only then that they launched a nationwide plan to find cases — distributing CDC-sanctioned test kits, easing the criteria for confirming cases and ordering health officials to screen patients, all without telling the public.
The documents come from an anonymous source in the medical field who did not want to be named for fear of retribution. The AP confirmed the contents with two other sources in public health familiar with the teleconference. Some of the memo’s contents also appeared in a public notice about the teleconference, stripped of key details and published in February.
Under a section titled “sober understanding of the situation,” the memo said that “clustered cases suggest that human-to-human transmission is possible.” It singled out the case in Thailand, saying that the situation had “changed significantly” because of the possible spread of the virus abroad.
“With the coming of the Spring Festival, many people will be traveling, and the risk of transmission and spread is high,” the memo continued. “All localities must prepare for and respond to a pandemic.”
In the memo, Ma demanded officials unite around Xi and made clear that political considerations and social stability were key priorities during the long lead-up to China’s two biggest political meetings of the year in March. While the documents do not spell out why Chinese leaders waited six days to make their concerns public, the meetings may be one reason.
“The imperatives for social stability, for not rocking the boat before these important Party congresses is pretty strong,” says Daniel Mattingly, a scholar of Chinese politics at Yale. “My guess is, they wanted to let it play out a little more and see what happened.”
In response to the teleconference, the Center for Disease Control and Prevention in Beijing initiated the highest-level emergency response internally, level one, on Jan. 15. It assigned top CDC leaders to 14 working groups tasked with getting funds, training health workers, collecting data, doing field investigations and supervising laboratories, an internal CDC notice shows. The memo directed Hubei province, where Wuhan is located, to begin temperature checks at airports, bus and train stations, and cut down on large public gatherings.
The National Health Commission also distributed a 63-page set of instructions to provincial health officials, obtained by the AP. The instructions ordered health officials nationwide to identify suspected cases, hospitals to open fever clinics, and doctors and nurses to don protective gear. They were marked “internal” — “not to be spread on the internet,” “not to be publicly disclosed.”
In public, however, officials continued to downplay the threat, pointing to the 41 cases public at the time.