MANILA — World Health Organization Director-General Tedros Adhanom Ghebreyesus has called on the international community to focus on taking actions to prevent the further spread of the novel coronavirus outbreak, instead of speculating on what China did or did not do in the early days of the outbreak.
“I cannot say they hid or they didn’t,” said the WHO chief during a press conference on Wednesday in Geneva, Switzerland, in response to a question referring to comments made by John MacKenzie, emeritus professor at Curtin University in Australia, and a member of the emergency committee of the International Health Regulations advising the WHO chief on the 2019-nCoV outbreak.
“$675 million is a lot of money, but it’s much less than the bill we will face if we do not invest in preparedness now during the window of opportunity that we have.”— Tedros, director-general, WHO
MacKenzie alleged that Chinese officials tried to hide cases in the early days of the outbreak in an interview with the Financial Times.
Tedros said if something was hidden, the world would have witnessed more cases spilling outside its borders, given how connected China is to the rest of the world. But the number of cases outside China is “very small,” he said.
“Even if China hides it, I don’t think the cases would be prevented from crossing the borders to other countries. So it really defeats the logic,” said the WHO chief.
But he said an after action review led by scientists can determine and reveal the truth.
“But again, I say, let’s check. Maybe we will have the after action review, and to see if something was hidden or not. Because I cannot say whether there was something hidden or not. I can only use some logic to really understand the situation,” he said.
In the meantime, he urged the international community to focus its actions toward investing in epidemic prevention and control. Global efforts to respond to the outbreak, prepare countries and accelerate research and development related to the 2019-nCoV will require an estimated $675 million for the period between February-April 2020, according to the Strategic Preparedness and Response Plan that WHO launched on Wednesday. More than 90% of the resources required will be for countries, priority being those with the highest risk but little capacity to detect and respond to an outbreak. The rest, or an estimated $60 million, is for WHO’s operations.
“$675 million is a lot of money, but it’s much less than the bill we will face if we do not invest in preparedness now during the window of opportunity that we have,” Tedros said.
“It’s time to act, not to speculate and spread fear, spread panic. That’s not the time,” he said.
The WHO chief has repeatedly praised China’s handling of the outbreak. But there’s been emerging anecdotal reports of authorities’ slow response to the outbreak in its early days. The mayor of Wuhan, the outbreak’s epicenter, said in an interview with China’s Central Television Network last month that he couldn’t make an announcement early on as he was awaiting clearance from the central government.
A local doctor in Wuhan who tried to sound the alarm on the mysterious disease producing pneumonia-like symptoms in December revealed how his actions were met with warnings by local police not to spread rumors.
The WHO aid chief’s positive remarks over China’s response has received some criticisms on social media, but some experts have expressed how WHO is likely in a delicate political position.
“Tedros understandably has his main aim to foster a cooperative relationship with China. This might best be achieved by not publicly criticizing the government,” said Lawrence Gostin, professor at Georgetown University in Washington, D.C.
Several member states at the ongoing WHO executive board meeting in Geneva have expressed support to China in its efforts to get the outbreak under control, but a few also raised concerns about Taiwan. eSwatini, formerly Swaziland, brought up the issue of Taiwan having limited access to international health regulations processes, and that Taiwan’s technical experts are often denied participation in technical meetings of WHO, effectively leaving millions of people in Taiwan vulnerable to epidemics like the 2019-nCoV.
But the representative from China argued that it has been in communication with Taiwan regarding the outbreak, and that it has even allowed Taiwanese epidemic prevention experts to come to Wuhan to investigate the epidemic prevention and control situation. The experts also took a field trip to Hubei Province’s disease control center and laboratories, among other things, China’s representative said at the executive board meeting.
Challenges in information sharing
On Tuesday, during a 2019-nCoV outbreak briefing to member states, Tedros mentioned how countries outside China have been slow in sharing complete information about cases, with WHO having received complete case reports for only 38% of cases. He said some high-income countries were well-behind in sharing vital information, which is important for WHO to assess how the outbreak is evolving, and provide the “most appropriate recommendations.”
“I don’t think it’s because they lack capacity,” he commented, saying that sharing information showcases countries’ commitment to defeat the outbreak.
On Wednesday’s press conference, Tedros said some member states have started to share data following his remarks during the executive board briefing.
Meanwhile, Mike Ryan, executive director of the WHO Health Emergencies Programme, addressed a question over whether China is sharing sufficient data to WHO, after concerns were raised at the U.S. Senate of the reliability of data the Chinese government has been sharing.
He said Chinese authorities continue to provide WHO daily case numbers as well as detailed epidemiologic and clinical descriptions of cases. However, authorities there have also started to face challenges in sharing detailed individual cases as case numbers continue to rise.
“You can imagine the challenge for country X that has 12 cases are very different to a country that has reported 4,000 cases yesterday. So I think we need to leave a little bit of leeway and room here. This is a challenge, and we’re very careful that we don’t want to overtax the system, but at the same time get the information we need,” Ryan said.
It would be ideal if WHO receives the most up-to-date information, not just from China but the rest of the world, he added.
“We say that to all member states. We say that now to every member state that has cases including China that we would like daily disaggregated data from them. And this is not so WHO has data … but for the world to have the evidence it needs to make good decisions in the coming days and weeks,” he said.
As of Feb. 5, there are 28,018 confirmed cases in China, and 563 deaths, according to the latest bulletin from China’s National Health Commission. Outside mainland China, there are over 240 cases to date, with the Philippines and Hong Kong each reporting two deaths.