Author: Jared Peacock
It was the end of December 2019. Patients queued outside Wuhan hospitals. The government chose ambiguous wordings on the breakout, but frontline medical staff knew they were dealing with a peculiar and dangerous pneumonia. Most community clinics were not equipped to isolate patients therefore refused to take in suspected cases of “viral pneumonia” with symptoms of coughing and fever. Wuhan Municipal Health Commission mandated that hospitals must treat patients on their own and stop transferring patients among hospitals. The hospitals became more congested. It was common for a patient to wait for hours before being examined. BGI Genomics Co. Ltd. found three SARS-like coronavirus cases out of samples collected from various Wuhan hospitals on December 2019, on 26, 29 and 30 December 2019 respectively. It mixed the genome sequence of the three cases and reported to national CDC meanwhile forwarded the three test reports to Wuhan Municipal Health Commission. Within the same day, the genetic sequencing company received a call from Hubei Province Health Commission, being ordered to halt on examining any novel coronavirus pneumonia case samples from Wuhan; furthermore, any existing case samples must be destroyed, could not be disclosed, and no relevant articles or data could be released to public.
At 3am on the same day, president of Jinyintan Hospital Zhang Dingyu and Party Secretary Wang Xianguang rushed back from yearly meeting, slept on cod and sofa in the office and at 6am called staff from all functions as well departmental directors and head nurses to report at their posts and cancelled New Year’s holiday break. In the early morning, Wuhan Central Hospital received a patient who was the owner of a clinic near the Huanan Seafood Market. He said they had recently received many fever cases and he himself started to develop symptoms. Emergency department director Dr. Ai Fen again “blew whistle” to the hospital’s public health department and medical administration, reporting that community clinics had taken in many cases and expressing concerns that “if emergency department doctors and nurses are infected the situation will be grave”. Concurrently, Wuhan Public Security Bureau was just starting to announce in “Safe Wuhan” blog that they investigated and punished eight Wuhan citizen “whistleblowers”, namely Dr. Li Wenliang from ophthalmology department of Wuhan Central Hospital, Dr. Xie Linka from oncology department of Wuhan Union Hospital, Dr. Liu Wen from neurology department of Hospital of Wuhan Red Cross Society and others, for spreading rumors, and that the Huanan Seafood Market would be shut down. The city of Wuhan was in preparation for the municipal and provincial level of CCP’s “two conferences” that would take place between 6-19 January 2020. Any mention about the epidemic was naturally considered disharmonious and must be silenced.
Dr. Ai Fen was called in for a talk with the hospital’s Inspection Department and reproached as “a professional who compromised on her principles to create rumors.” She brought up that there was human to human transmission but was met with no official reply. The hospitals stipulated that medical staff could not openly discuss cases nor use text messages or photos that could be evidence traced. They were only allowed to verbally communicate cases when changing shifts. And they should not give information to the patients. Dr. Liu Wen from neurology department of Hospital of Wuhan Red Cross Society was also questioned by the police and ordered to sign a written record of his reprimand. Dr. Li Wenliang was again interrogated by the local police station and ordered to sign a “Reprimand Letter” for spreading false information on the internet. Wuhan Union Hospital oncology department Dr. Xie Linka was questioned by phone by the police for spreading information on “pneumonia of unknown etiology”. Every major hospital started to enforce “guidelines” and “screening criteria”, forewarning medical staff to keep information strictly confidential. The confirmed cases must meet three stringent criteria – having contact with Huanan Seafood Market, symptom of fever, and tested viral infection postive. Doctors widely worried that this filtering process would leave out fever cases in community clinics and cases with no contact to Huanan Seafood Market, but their voices were muffled under political pressure. Several hospitals had been warned by their administrative superiors to “not to insert bad influences”. During transporting of patients, medical staff took no protective measures besides wearing facial masks. On 8 January 2020, Dr. Li Wenliang came to contact with an elderly female glaucoma patient and was infected. As recalled by Dr. Ai Fen, he “did not take special protection. The patient came without a fever, so he was careless.” Dr. Xiong Nian from Hospital of Wuhan Red Cross Society recalled that by mid-January 2020 the entire oncology department staff were infected, including 12 doctors and 14 nurses.
According to a 29 January 2020 article in The New England Journal of Medicine, based on analysis of Wuhan “pneumonia of unknown etiology” cases between 10 December 2019 and 4 January 2020, human to human transmission could trace back to mid-December 2019, in its early stages “the epidemic doubled in size every 7.4 days”, and “asymptomatic” child case was recorded. However the citizens of Wuhan had no information on the epidemic or knowing that medical professionals were fighting around the clock under the risks of being reprimanded and infected. Their focus was on the upcoming Chinese Lunar New Year Spring Festival and looked forward to good fortunes of 2020 Year of the Rat. Close to three million among 11 million citizens of Wuhan are resident migrant population who would travel home for Spring Festival every year. Wuhan is the annex of transportation in central China, situated at on average 1,000-kilometer-distance from Beijing, Shanghai, Guangzhou, Chengdu and Xi’an. With three train stations the city weaves a densely threaded web of railroads. Yangtze River ferries cruise by. Domestic and international flights are frequent. Wuhan Tianhe Airport is the first gateway airport for 144-hour non-visa entry in central China with direct flights connecting to more than 40 international cities. The Spring Festival travel rush was expected to last 40 days from 10 January till 18 February 2020, with estimated 15 million travelers according to a 2019 year-end government meeting. The CCP officials liked to proudly claim Spring Festival travel rush as “the world’s largest cyclical migration’ for exerting the efficiency and authority of a powerful nation. In spite of “whistleblowing” from Wuhan’s medical front, the Spring Festival travel rush kicked off on 10 January 2020 on schedule.
Two days later, Beijing Ditan Hospital found the first confirmed case in Beijing. Thailand also reported a confirmed case. The patient arrived Thailand on a flight from Wuhan but had no contact with the Seafood Market. Wuhan Municipal Health Commission bureau chief Wu Fengbo addressed new instructions to Wuhan Central Hospital that “pneumonia of unknown etiology” cases must be reported with “extra caution”. Under his decree, any viral pneumonia case would need to first go through every test within the hospital, analyzed and confirmed by hospital staff specialists before being reported to district health commission. Then the district disease prevention department need to take samples. And only after district, municipal and province level verifications all lead to confirm “pneumonia of unknown etiology” as well as “obtaining permission from province level health commission”, can the case be reported to higher authority. This “extra caution” reporting procedure practically meant to discourage hospitals from “try to report” cases.
For 12 days around the “two conferences” period, Wuhan Health Commission declared “no new confirmed cases”. When infrared temperature detectors were put up at the three train stations, travelers did not slow down their steps because they thought they were installed for flu prevention.
As the “two conferences” came to close on 15 January 2020, the national CDC immediately activated first level national response protocol. Japan discovered its first case on the same day. News on epidemic was instantly subdued by other headlines. The CCTV reported at length on China and the United States signing a trade deal in Washington D.C. The Party’s mouthpiece Qiushi Magazine published “Why China Economy is Unique and Promising”. Government backed media outlets chimed in to depict China’s prosperous future, some exaggerating how CCP’s Vice Prime Minister Liu He was “graciously unscathed” when President Trump waved his fist in air after signing the deal.
The spread of epidemie eventually could not be stopped by political maneuvering. Large numbers of previous suspected cases were not reported for reasons that they did not meet the Health Commission’s criteria of having contact with Huanan Seafood Market or symptom of fever. After closing of the “two conferences”, the procedure for reporting suspected cases was relaxed to include those having no contact with Huanan Seafood Market. The number of cases hospitals reported to disease prevention bureaus rose sharply, and the subject of epidemic entered ordinary citizens’ horizon. But the government insisted that it was “preventable”, “containable” and had limited possibility in human to human transmission. Wuhan Baibuting neighborhood committee was in preparation to organize “striving to achieve affluent society dream fulfillment” 10,000-family-banquet. Some staff “whistleblower” suggested to cancel the event but was disapproved by the leaders. On 8 January 2020, the 10,000-family-banquet at Baibuting Garden neighborhood in Jiangan District of Wuhan was launched as scheduled, 14,000 dishes were on display in the main hall and nice separate rooms, with more than 40,000 families attending the Chinese Lunar New Year pre-celebration.
When national CDC team arrived at Wuhan thereafter, Academician of China Academy of Engineering Zhong Nanshan took the lead. He was a hero doctor the government had branded out of the SARS combat. After briefly interacting with clinical doctors, he entered closed-door meetings then flew back to Beijing overnight. Zhong Nanshan had been in politics long enough to know the weight of expert statement on “human to human transmission” and on applying “highest level infectious disease management protocol”. He understood the gravity of the situation, but he needed time to calculate his moves. Those who fall into CCP politics are easy to forget the actual spectrum of the universe, forget humanity, forget natural laws and lessons from history – each minute of delay and deceit in epidemic control will gravitate towards a bigger disaster that has to be ultimately paid back. While the CCP government let precious time slip through, whistleblowers like Dr. Li-Meng YAN and other fighters had transmitted information and intelligence to the Whistleblower Movement. On 19 January 2020, Lude Media in the United States was the first in the world to announce in live broadcast that the epidemic in Wuhan had three features – human to human transmission, strong mutation, and would soon grow into global pandemic.16
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