The Thread of The Donald

On Jan. 22, the Chinese Centers for Disease Control finally admitted that the novel coronavirus was “highly infectious”—though it maintained, again minimizing the danger, not as virulent as SARS. By then, it had already spread from Hubei province to 12 other Chinese districts, plus Japan, South Korea, Taiwan, and Thailand. And those were just the confirmed cases that had been reported to WHO. By Jan. 24, it had also been reported in Hong Kong, Macao, Vietnam, Singapore, and the United States. Yet on that same day, WHO reaffirmed its advice “against the application of any restrictions of international traffic.”

Strangely, although WHO recommended that China “conduct exit screening at international airports and ports in the affected areas,” it did not recommend entry screening by other countries receiving passengers from China. It recommended temperature checks upon departure from China, but remained oddly vague about entry checks, warning that they “may miss travelers incubating the disease or travelers concealing fever during travel and may require substantial investments.” Yet in the very next sentence, WHO admitted that “the majority of exported cases were detected through entry screening.” Reading between the lines, WHO’s message was: Don’t do anything. Let China handle this.
That message was taken up by other countries. For example, Australia’s chief medical officer, Brendan Murphy, explicitly cited WHO advice when he concluded that “they will stop exits from China which is a more effective way” to fight the virus than “banning direct flights from China.” The latter, WHO advice had led him to believe, was “not a public health measure.” In the United States, the Washington Post published an op-ed chastising the United States and other countries for undermining global health cooperation by pandering to public demands for action.

On Jan. 30, WHO’s Emergency Committee reluctantly declared the coronavirus outbreak a “Public Health Emergency of International Concern.” That the declaration was reluctant can clearly be read between the lines of the statement, in which WHO emphasized that the declaration “should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency.” WHO recommended that other countries “put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures.”

But once again, WHO recommended against “any travel or trade restriction,” implying that such actions could “promote stigma or discrimination.” But this time it went even further, reminding countries that “interfere with international traffic” that they must “send to WHO the public health rationale and justification within 48 hours of their implementation.” When the United States banned noncitizens from entering the country from China on Jan. 31, academic critics and a WHO spokesperson duly condemned the restrictions as “counterproductive” and likely to cause “social disruption.” When Australia and Singapore followed the United States’ lead, a Chinese Foreign Ministry spokesperson said the United States had “unceasingly manufactured and spread panic.”

On Feb. 3, Tedros reiterated WHO’s advice against restricting travel from China. He said that if “it weren’t for China, the number of cases outside China would have been very much higher,” again implying that other countries should rely on China to control the outward spread of coronavirus, instead of imposing restrictions of their own. The next day, Tedros called on countries to reverse their travel restrictions, which he claimed “can have the effect of increasing fear and stigma, with little public health benefit.”

Many countries followed WHO’s guidance, including many poor ones with insufficient public health infrastructure and dependent on the support of international organizations such as WHO. Pakistan, an ally of China which had suspended flights from various Chinese cities on Jan. 31, reinstated flights on Feb. 3, only to suspend them again on March 21. Ethiopia continued flights to and from China despite the pleas of other East African countries desperate to prevent the introduction of the virus into Africa via Addis Ababa’s airport, the continent’s main gateway to China.

As late as Feb. 26, Tedros gave a speech in which, beggaring belief, he claimed that “we are not witnessing sustained and intensive community transmission of this virus, and we are not witnessing large-scale severe disease or death.” On the same day, his own organization reported 81,109 confirmed coronavirus cases in 38 countries and Taiwan, including 2,762 recorded deaths, and a risk assessment of “high” for the entire world. Yet once again, on Feb. 29, WHO confirmed that it “continues to advise against the application of travel or trade restrictions to countries experiencing COVID-19 outbreaks.”

 

In a bizarre case of self-contradiction, WHO reasoned that “restricting the movement of people and goods during public health emergencies is ineffective in most situations and may divert resources from other interventions,” even as one of its chief epidemiologists, Bruce Aylward, praised China for its “bold approach to the rapid spread of this new respiratory pathogen” that had “changed the course of what was a rapidly escalating, and continues to be, deadly epidemic.” WHO’s odd message seemed to be that China was right to lock down its population, but other countries shouldn’t dare lock out China.

Of course, China now has some of the world’s tightest travel restrictions on international travel, barring entry by nearly all foreigners (including those with residence permits) since March 28. Perhaps in a nod to WHO guidance that such restrictions should “be short in duration, and be reconsidered regularly as the situation evolves,” China characterized its move as a “temporary measure” that “will be calibrated in light of the evolving situation.” As of late May, the situation still hasn’t evolved sufficiently for China to lift its global travel ban. There’s been no word from Tedros or WHO about the appropriateness of China excluding the world now that China itself is relatively virus-free—the reverse of the situation at the beginning of the pandemic.

U.S. President Donald Trump and his supporters aren’t alone in thinking that “the World Health Organization has been curiously insistent on praising China,” as Trump wrote in a May 18 letter to Tedros that threatened to permanently cut U.S. funding and withdraw from the organization. More than 110 countries have now demanded an investigation into WHO’s handling of the coronavirus crisis. Time will tell just how impartial and independent that investigation turns out to be. The World Health Assembly’s official resolution establishing the investigation, tellingly, does not mention China, which may be why China ultimately agreed to co-sponsor it. The resolution also suggests that the investigation might take advantage of “existing mechanisms, as appropriate.” Translation: Don’t be surprised if WHO ends up evaluating itself. And be even less surprised if that evaluation ultimately pins no blame for the coronavirus pandemic on WHO—or on China.

 

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