Cast your mind back, if you will, to the beginning of the pandemic, before the World Health Organization had coined the term Covid-19. Back then, it was the “Wuhan virus”, a mysterious pathogen from a city that few people outside China had visited.
On 12 January 2020, China’s Center for Disease Control and Prevention (CDC) published the virus’s genome on an international database, permitting scientists anywhere in the world to see that it was a coronavirus closely related to Sars – the pathogen that had caused a mini-pandemic in 2002-2004.
On 20 January, Dr Zhong Nanshan – well known in China as the first person to have spoken out in 2003 about the threat posed by Sars – appeared on China Central Television to break the news that the Wuhan virus – or Sars-CoV-2 as it was now officially known – was “certainly transmissible from human to human”.
Three days later, China’s president, Xi Jinping, instructed officials in Wuhan to lock down the city, placing 11 million under an unprecedented three-month quarantine. The problem was clinicians had been warning of a new Sars-like illness since 27 December 2019 and by late January cases had already appeared in Thailand, Japan and Korea. The Wuhan virus had gone global.
What accounts for China’s failure to prevent the pandemic? After all, unlike Sars, which was initially mistaken for bird flu, Sars-CoV-2 had been rapidly identified by several laboratories in China. And after Sars, China had overhauled its national disease reporting system to ensure it would not be caught flat-footed a second time. Wuhan also boasted some of the best hospitals in China and a world-class virology institute.
As Dali Yang, a professor of political science at the University of Chicago and an expert on Chinese bureaucracy, puts it in his new book, Wuhan: How the Covid-19 Outbreak in China Spiraled Out of Control, China began with a “remarkably strong hand” but quickly squandered its “authoritarian advantage”. Why? Was it medical myopia – a refusal to recognise the monster at its door – bureaucratic incompetence, or something more sinister?
Yang has little time for claims that the virus was a product of a “lab leak” from the Wuhan Institute of Virology (WIV), devoting just one paragraph to the theory. Instead, he focuses on the bureaucratic obfuscation and missteps that allowed the outbreak to spiral out of control.
Frontline physicians, he explains, were initially fearful of reporting their suspicions to Beijing in case they were accused of scaremongering. Officials at the municipal level were similarly reluctant to sully Wuhan’s reputation as a “healthy city”, giving the go-ahead for a mass gathering of provincial Communist party officials on 15 January. The result was that it was not until New Year’s Eve that the CDC’s director, George Gao, dispatched a specialist emergency response team to Wuhan, after learning about the outbreak via social media.
Photograph: Frank Leonhardt/EPA
The second mistake came when the team from the national health commission decided to cordon off the Huanan market in Wuhan, even though by early January clinicians were already seeing patients with no connection to the market. The third came when the Wuhan health commission issued guidelines on how to diagnose the disease, stipulating that in addition to the usual clinical symptoms, patients had to have had a link to, or been in proximity to, the market. This meant that cases with no apparent connection to the market were ignored, lulling authorities into a false sense of complacency as the virus spread stealthily under the radar.
The result was that rather than drawing on its post-Sars warning systems and its considerable epidemiological expertise, China prioritised dominance and control over transparency, censoring social media posts about the spreading contagion, disciplining medical whistleblowers and squandering its reserves of trust.
Citing a study that showed that if Wuhan had locked down five days earlier, Covid-19 cases in China would have been two-thirds lower, Yang describes the four-week period from 31 December to the lockdown of Wuhan on 23 January as “among the most important weeks in the history of pandemics”.
He concludes his book by arguing that if, rather than using its powers to silence whistleblowers and issue positive propaganda messages, Beijing had been open and honest with the citizens of Wuhan, it could have enlisted people’s memories of Sars and fear of infection to encourage the voluntary adoption of social distancing measures, thereby limiting or avoiding catastrophe.
I am not so sure. By backdating mutations in the virus, scientists estimate it most likely infected someone as early as November or late October 2019. In other words, long before patients began presenting with unusual pneumonias, the virus had probably already escaped Wuhan and was set to become a global problem.
Aimed principally at an academic audience, Yang’s book is hard going at times – I could have done without the bold subheadings, such as “The Stability Maintenance Regime”, that pepper each chapter. However, as a forensic account of the initial response to the outbreak and China’s dysfunctional bureaucracy, I doubt it will be bettered.
For a more engaging, if episodic, take on those early, fear-filled weeks of the pandemic, readers should turn to Liao Yiwu’s Wuhan. A Chinese dissident best known for his poems about the Tiananmen Square massacre, Liao is an outspoken critic of the Chinese regime.
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From exile in Italy, he has written an extraordinary “documentary novel” that draws on official Chinese websites plus social media posts and blogs by citizen-reporters, to create a ground-level view of the crisis that mixes fact and fiction. The main protagonist is “Kcriss”, a former Chinese state TV host who travels to Wuhan to shed light on the rumours and ends up taking a job at a funeral home.
It does not take Kcriss long to realise that Wuhan’s crematoriums are working overtime and that the official death figures are a lie. But nothing can be allowed to stand in the way of the party and its message: “One Belt, One Road, do not look back.”
Unlike Yang, Liao does not dodge the questions surrounding the Wuhan Institute of Virology. However, his account, which draws largely on secondary sources, is inconclusive and he is unable to say whether “an evil” was committed there. On the question of whether Wuhan could and should have been locked down sooner, however, he and Yang are in accord. “Like a high-speed train rushing towards the edge of a deep abyss… the city was closed too late.”
According to Yang, this failure was down to a mixture of cognitive bias – the expectation that the outbreak at the market would be self-limiting – and China’s multilayered party-state hierarchy, which followed its own institutional political logic, rather than that of the virus.
The tragedy is that Chinese authorities appear to have learned little from their mistakes. Last month, the Shanghai-based virologist Zhang Yongzhen was evicted from his lab at short notice, apparently as a punishment for sharing the genome of the coronavirus without permission.
On 5 January 2020, Zhang had been among the first to sequence the virus and, concluding it was spreading from person to person, urged the authorities to act. When they prevaricated, he decided to circumvent official channels and publish the genome on virological.org, where it was accessible to scientists anywhere in the world. A day later, the CDC followed suit.
In response to his eviction, Zhang camped outside his lab in protest. “I won’t leave, I won’t quit, I am pursuing science and the truth!” he announced in a Weibo post that has since been deleted. Last week, he and his team were allowed back into the lab for the “time being”. Unfortunately, in China bureaucrats have long memories and truth is determined by the party, not scientists.
Mark Honigsbaum is a lecturer at City University of London and the author of The Pandemic Century
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Wuhan: How the Covid-19 Outbreak in China Spiraled Out of Control by Dali L Yang is published by Oxford University Press (£26.99). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply
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Wuhan: A Documentary Novel by Liao Yiwu is published by Polity (£25). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply