Just six weeks ago, China appeared to be reeling under the impact of the coronavirus epidemic. Today, as Covid-19 deaths in other countries outnumber those in China, the world is looking to it for answers. At the same time, the lifting of restrictions in Wuhan, where the outbreak began, is being met with anger and anxiety.
The FT’s Beijing correspondent Yuan Yang has been in China throughout the outbreak, reporting on how surveillance technology is being used to track cases of the disease and how official figures may be hiding unreported cases. Yuan recently wrote about China’s efforts to appear as a global leader as the pandemic continues around the world.
On Thursday, April 9, Yuan took some time to answer your questions in the comments below this story. Here are the highlights.
From FT commenter Angry Pig: The doctor [Li Wenliang] was silenced by local police. (. . .) The strange pneumonia in Wuhan was in the news in early January about people that had visited a local market, but it was presumed to be only from animal to human. By mid-January, China reported that there were human to human transmissions, then shutting down Wuhan shortly after. When did the authorities find out about it?
Yuan Yang: On this question, and the general issue of a “cover-up”, we know that on December 31 the Wuhan local government told the WHO’s Beijing office about victims of a novel pneumonia. A few days later, whistleblowing doctor Li Wenliang was summoned by local police and punished for telling other doctors to take precautions against what he thought was Sars in a private social messaging group. (Sars is also caused by a coronavirus, similar to the virus that causes Covid-19.)
Although local police have issued his family an apology, Li’s case struck a nerve partly because many in China have been punished for online speech deemed offensive to the government, even in private messaging groups. Caixin, possibly China’s best local investigative news agency, reports that on January 3 the National Health Commission “ordered institutions not to publish any information related to the unknown disease, and ordered labs to transfer any samples they had to designated testing institutions, or to destroy them”.
Managing an outbreak of a novel disease is a vast challenge for any government, but suppressing speech and reporting of the issue cannot help.
From FT commenter Vitasoy: How is China dealing with the claims from the western media that their data is inaccurate? (. . .) Could you also explain why respected medical journals like the Lancet have accepted and published the data coming from China, but the western media still remain sceptical of them?
Yuan Yang: Both local and foreign media (such as ours) have criticised the government’s refusal to publish its asymptomatic case figures. The government subsequently started to announce its asymptomatic cases daily, which currently are much higher than the symptomatic cases (when looking at domestically-generated cases). I’m glad to see this increase in transparency, partly as a result of media coverage.
Statistics are political: a high case count can contribute to the sacking of local officials, as we have seen happen already. In addition, a tiny fraction of the population is ever tested. However, the official numbers are the best we have to go on right now, which is why we continue to publish them, although we should always add the warning labels that epidemiologists give about the scale of undercounting.
From FT commenter GeorgeZ: How do you evaluate China’s competence in fighting against coronavirus and overall competence in its governance (. . .) WHO now is paying a high price for praising China, as Trump threatens to freeze WHO’s funding today as he said WHO was too China-centric. Do you agree with WHO’s statement or do you agree with Trump?
Yuan Yang: China’s foreign ministry has made a priority of promoting the idea that the government has done great things for the world in its approach to Covid-19. As a result, we shouldn’t be surprised if China has put great pressure on the WHO as well. The WHO press conference their team of experts gave in Beijing was organised by the local government and, even when repeatedly asked, the team refused to discuss how China could improve its practices.
I think it’s perfectly possible to maintain that the Chinese government — at central and local levels — has made good decisions (social distancing) as well as terrible ones (the initial cover-up). If we err on one side, I would prefer to err on the side of criticising any government, in order to help them improve. I would also recommend David Pilling’s interview with the WHO chief.
From FT commenter JohnC: Tracking via apps in China and South Korea has seemed to depend on cultural obedience to the government. Do you think it can work in the west?
Yuan Yang: I don’t think obedience to the government is an important factor in people’s use of tracking apps. Interestingly, the patchwork of tracking apps across China shows that there is little co-ordination in this respect between localities and the central government.
Instead, people download tracking apps because the network effect makes it more convenient to do so. If your bus to work, workplace and local cafés all ask you to flash an app showing you have not left the city in the past 14 days, then you will end up using it. The bus is government-run, but the other two places are privately minimising their own risk of contagion (with the fear of government reprisal if a cluster of cases is found there, of course).
From FT commenter jlock: Seeing as there is a shortage of testing all over the world, how much trust should we be putting in the official numbers being reported by the CCP [Communist Party of China]?
Yuan Yang: China for a couple of months withheld “asymptomatic” case numbers, defined by the National Health Commission as cases where the Sars-cov-19 virus was found in the patient’s samples, but the patient showed no clinical symptoms. Apart from that issue, there’s a question as to the accuracy of the symptomatic case count.
The local and foreign epidemiologists we have interviewed on this have said they don’t trust the absolute level of cases, and that the truth could be 10x the official number. This is partly because of a lack of test coverage and the non-random sampling of tests: most cases are not life-threatening, which is obviously good, but also means people can go undiagnosed for longer while they are spreading the disease.
However, epidemiologists also say they do believe the overall trend — the decline in cases — even if they don’t trust the level. As alternative measures of success in containing the virus, I would suggest looking at hospital bed spaces, and how busy doctors are, as second-order measures. Measures of economic activity and of movement, such as Baidu’s migration index, are third-order measures because they measure confidence as well as the easing of the actual virus.
For us in Beijing, the big question is: when will the central government think it is safe enough to gather officials from across China for its annual Two Sessions political congress, which has already been delayed by at least a month?
FT commenter Obuasi Man: Is China doing any leading bio-pharmacological research into finding a cure for this disease that came from its territory?
Yuan Yang: This is a very interesting area. Chinese researchers have been testing some treatment drugs. Chloroquine has been recommended as a treatment by the National Health Commission. Renmin Hospital of Wuhan University has just finished a small clinical trial for hydroxychloroquine, which found initial positive effects for sufferers with mild symptoms. Both hydroxychloroquine and chloroquine belong to the same family of drugs, and can have severe side-effects. Chinese doctors have adjusted their treatment doses for chloroquine because of that.
There is also research looking at the use of convalescent plasma — blood taken from recovered patients — as a treatment.
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