Author: Jared Peacock
Communist China’s Center for Disease Control and Prevention announced cases of “pneumonia of unknown etiology” in late December 2019 with Wuhan Huanan Seafood Market as the designated point of origin for infection. The cases emerged between mid-November to mid-December, as well cases claimed no contact with the Market, were not sufficiently documented. Wuhan’s frontline medical professionals were uninformed about the upcoming breakout. They fought it hard, their professional and human qualities stretched to the extreme, not knowing they were at the center of a soon-to-be pandemic and that they were facing personal health as well as political risks.
On 16 December 2019, Wuhan Central Hospital emergency department director Dr. Ai Fen received a patient in high fever who was then transferred to the department of respiration for bronchoalveolar lavage and tested to be coronavirus infection. Other hospitals also started to find patients whose CT results showed “ground glass opacities on lungs”. On 25 December, the No. 5 Hospital of Wuhan digestive department director Dr. Lu Xiaohong learned that two Wuhan hospitals had medical staff including some from the respiratory department infected by “unknown etiology” and they were isolated for treatment. She immediately warned nearby schools of potential risks of human to human transmission. The following day, Guangzhou Vision Medicals Genetics Science Company Limited tested and found among the unknown virus samples from Wuhan Central Hospital to be 87% identical to a bat virus and 81% identical to the SARS virus.
The number of patients increased and cross-hospital collaboration became more common each day closer to New Year’s. Many doctors suspected that it was not a normal pneumonia, but they could not compare cases for analysis without the overview information. In the medical system of Communist China, SARS is more than the name of a virus, it is a sensitive political topic. The government is hoping for people to forget that it tried to cover up the 2002-2003 SARS outbreak to the world thus exacerbated the virus spread, the subject on the origin of SARS virus and exact number of deaths is a taboo. It only wants people to remember two things – firstly, SARS came from masked palm civet; secondly, be grateful for the government for containing the outbreak. Any mention of SARS that are incompatible with the Party’s narratives would be trespassing the ‘red line’. Anyone who even suspected the “pneumonia of unknown etiology” to resemble SARS would be at political risk. The frontline medical professionals in Wuhan were aware of perils to come, but many did not hesitate to “blow whistles”.
On 27 December 2019, Hubei Province Hospital of Integrated Traditional and Western Medicine respiratory and severe case unit director Dr. Zhang Jixian warned the medical bureau of the central government that this atypical pneumonia was caused by a virus. On the same day, Wuhan City Jianghan District Center for Disease Control and Prevention received a family of three patients. Doctors thought about group infection but could not identify infectious pathogen. Several hospitals organized urgent cross-departmental consultation meetings. Hubei Province Hospital of Integrated Traditional and Western Medicine involved specialists from a multitude of fields – respiratory, infectious disease, cardiovascular, ICU, radiology, pharmacology, clinical studies, medical affairs – to analyze each case, the specialists invariably agreed to report to municipal and provincial health commission.
In spite of doctors “blowing whistles”, there was no official response. The 2019 year-end saw a bizarre phenomenon in Wuhan’s medical sector – the back team wearing holiday cheers in contrast to frontline staff worn out. While medical company holding yearly gala, praising employees, officials making speeches, jubilating to crescendo with performances, games and lucky draw, the hospitals had not one minute to lose. Jinyintan Hospital was the first to be ordered to take in groups of patients. Its medical staff put on highest level of protective gear, the ambulances whistling across the city and must be completely disinfected after each time picking up a patient.
On 30 December, Wuhan Health Commission issued two documents, prohibiting medical facilities and individuals from publicizing information related to pneumonia and treatment without authorization, and that they must report by 4pm on that same day the “pneumonia of unknown etiology” cases they had dealt with in the previous week. This regulation applied to every department and everybody, and the training materials must remain strictly confidential. It stated that taking photos and leaking information would lead to severe consequences and punishment. On the same day, Wuhan Central Hospital received from Beijing CapitalBio MedLab test results on its patients among which labeled “SARS Coronavirus”. Dr. Ai Fen of the emergency department immediately “blew whistle” to public health and infection control department. That evening, ophthalmologist Dr. Li Wenliang posted the screenshot of this test report in the Wuhan Medical University class 2004 WeChat group, alerting doctors in the chat group to take precaution for themselves and their families. Meanwhile, Dr. Liu Wen and Dr. Xie Linka shared this information in “Union Neurology Department” and “Comprehensive Cancer Center” chat groups. According to Dr. Li Wenliang, he did not directly get the test result from Dr. Ai Fen but from “communicating with colleagues”, and he saw the Wuhan Health Commission document later that evening. At 1am in the following morning, Dr. Li Wenliang received a call that demanded him to go to Wuhan Health Commission for a talk. During the day time of 31 December, he was again called to the hospital’s Internal Investigation department to write a “Reflection and Self-Criticism on Spreading False Information” and was told to be reprimanded.
According to the 3 March 2020 report by Citizen Lab of University of Toronto, social media companies in Communist China such as Tencent and YY were given official guidelines regarding “how to manage information on Wuhan’s “pneumonia of unknown etiology””. On 31 December 2019, a day after Dr. Li Wenliang and seven others “blew whistles” on WeChat, YY added 45 words on the censorship list, including “pneumonia of unknown etiology” and “Wuhan Seafood Market”. Words like “pathogen”, “Li Wenliang”, “Central government”, and “epidemic” were subsequently added to the list.
Dr. Li-Meng YAN the researcher virologist at WHO reference lab at Center for Infectious Disease Epidemiology of School of Public Health of University of Hong Kong was the first scientist to investigate on the epidemic in Wuhan in late December 2019. Communist China refused to let in foreign scientists including those in Hong Kong to probe into the SARS-like pneumonia after it announced the outbreak. Dr. YAN’s superior WHO advisor Dr. Leo Poon asked Dr. YAN to secretly research on the breakout. Dr. YAN obtained her medical doctor degree and medical license in China mainland therefore had a substantial network among medical scientists and doctors in the mainland though she focused on virology research in Hong Kong. When she found out that the entire medical field was silenced, she turned to her friends at the CDC for more information. By analyzing chat group discussions among doctors from various hospitals, she learned that doctors collectively believed this pneumonia was related to SARS. But due to political pressure, many doctors replied “we can’t discuss that. But we all must wear masks.” Dr. YAN learned from other scientists’ group chats that Wuhan had already cases of family infection. She believed there had long been human to human transmission. From both clinical medicine and virology analysis, Dr. YAN foresaw severe consequences down the road and felt compelled to report to WHO urgently. When she reported to Dr. Leo Poon, he told her not to escalate the research result or report again, furthermore warned her not to cross the ‘red line’, for otherwise she might be ‘disappeared’.
Chinese people in the mainland, Hong Kong and Taiwan had their paths diverged again on the last day of 2019. People in the mainland were unaware of the epidemic. Those who made inquiries were either ridiculed for rumoring or laughed at. Wuhan Municipal Health Center issued the first announcement on pneumonia, kept the number of cases at 27 and stated that no apparent human-to-human transmission had been found and no medical staff infected. In reality, many hospitals’ daily received cases exceeded the reported total number but they could not get the truths out. Down in Hong Kong, protesters rallied “Five Demands, Not One Less”, formed human chains that stretched for miles, welcoming the arrival of 2020 while chanting “Liberate Hong Kong, Revolution Now.” Police used water cannon, gas and rubber bullets to clear protesters in Nathan Road in Mong Kok. 18 nations sent an open letter to Hong Kong Chief Executive Carrie Lam, urging her to peacefully address the demands of Hong Kong people. On the south side of the Strait, Taiwan Center for Disease Control sent an email to WHO, in which it particularly reported “atypical pneumonia cases” in Wuhan and that “the cases have been isolated for treatment”. Taiwan officially implemented a screening process at the customs and ports based on a real possibility of human to human transmission and dispatched personnel to screen passengers aboard flights from Wuhan to Taiwan.
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