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Children receive a drip on the stairs at a children’s hospital in Beijing on November 23, 2023. (Photo by Jade Gao/AFP via Getty Images)

China Says This New Outbreak Is Nothing to Worry About. How Can We Be Sure?

Less than four years after Covid, as another respiratory illness spreads in China, we’ve learned nothing from the pandemic, writes Alina Chan.

Two weeks ago, Taiwanese media reported an outbreak of pneumonia in several northern regions of China. Footage showed crowds of masked parents and children at a hospital in Beijing. Sick children attached to intravenous drips filled the lobby of another hospital in Liaoning as they waited hours to see a doctor. 

These reports were immediately flagged by the Program for Monitoring Emerging Diseases (ProMED), a Boston-based international organization that scours the web for signs of unusual health events around the world. ProMED analyst Dan Silver said in his initial report that “it is too early to project whether this could be another pandemic but as a wise virologist once said to me, ‘The pandemic clock is ticking, we just do not know what time it is.’ ”

Since then, Beijing schools have canceled classes. Doctors’ offices in the Chinese capital are reportedly overwhelmed. All signs point to a healthcare system struggling to cope with a spike in cases. 

Last week, Taiwan’s health ministry urged the elderly, children, and people with poor immunity not to travel to China unless necessary. In the U.S., a group of Republican senators has called for a travel ban to and from China until we know more about the epidemic. (Meanwhile, the WHO has advised against governments imposing travel restrictions and has not recommended any measures for people visiting affected cities. The Centers for Disease Control in the U.S. did not respond to questions about whether travelers from China are being screened for respiratory infections.)

For those of us watching from afar, with the memory of Covid still fresh, the initial scenes prompted an obvious—and terrifying—question: Could this be the start of another global pandemic? 

(Video via ABC News)

After the World Health Organization took the immediate—and unusual—step of making a public request that China supply information about its latest outbreak, officials there denied a new virus was to blame. Instead, they claimed that a surge of flu and other bugs in the nation’s first winter without a Covid lockdown had led to the chaos.

So much about this story is hauntingly similar to the beginnings of the Covid pandemic four years ago. At the end of 2019, an unnamed Taiwanese source first spotted Chinese social media messages about SARS-like cases spiking in Wuhan and alerted ProMED. ProMED then became the first organization to publicly warn the world about the outbreak on December 30, 2019. 

Then, in early 2020, when news outlets started buzzing about the frightening new respiratory virus, China censored vital information about human-to-human transmission. Not only that, but China penalized healthcare workers for trying to speak the truth. Li Wenliang, the ophthalmologist who raised the alarm about Covid, was punished by authorities for “spreading rumors.” He died of the disease one month later. 

By the end of January 2020, Wuhan was locked down after Chinese officials acknowledged that the virus could be transmitted between people, with President Xi Jinping describing the outbreak as a “grave situation.” 

Now, less than four years later, some parents in China are pushing back against their secretive government, complaining that authorities are concealing or downplaying this latest respiratory disease. One Beijing resident told journalists that parents could not report illnesses at schools and in class groups, stating that: “If you have symptoms such as fevers, cold, cough, and become hospitalized, you can privately ask the teacher for leave but cannot chat about these issues within the class groups, as these are considered state secrets. Everything is a state secret.” 

Based on the limited information they have, many public health experts believe this recent outbreak is most likely not due to a new pathogen but a mix of winter bugs. But even if that is the case, this surge could still spell major health risks for the public. According to Annie Sparrow, a clinician and associate professor at the Icahn School of Medicine, the bacteria causing some of these pneumonia cases is most likely resistant to the class of antibiotics deemed safe for children under eight. 

But even if experts are not too concerned about this latest wave of illness, their analysis is hampered by the inability to obtain more details and verify claims made by the Chinese authorities.

Global experts now have no measure of the number of cases, symptoms, or mortality rates caused by this latest illness. Nor do we know how much testing China has done to rule out novel viruses, worrying mutations, or antibiotic resistance in this outbreak.

But believe it or not, there are ways to get around China’s censorship machine—or censorship by any country. 

For one, scientists around the world can test wastewater from passenger planes coming to their countries from China and screen for new pathogens. As was demonstrated during the pandemic, developed countries are capable of collecting samples from travelers and gathering information for contact tracing. This kind of surveillance would accelerate the detection of novel pathogens and help to pinpoint when an epidemic started. 

Second, the WHO and national intelligence agencies should do everything they can to incentivize the rapid transfer of lifesaving information. This includes establishing secure, encrypted communication methods that give whistleblowers confidence their identities will be protected. That means protecting and empowering whistleblowers who are taking huge risks to share evidence of an outbreak. 

But scientists themselves have been guilty of sitting on information that is vital to public health.

At the start of the Covid pandemic, the coronavirus genome sequence was needed in order for vaccines to be designed, but it was released only after scientists were called out on Twitter by Jeremy Farrar, a prominent British scientist. Up until that point, the sequence was sitting in a U.S. database at the National Center for Biotechnology Information (NCBI), part of the National Institutes of Health, and subject to an embargo. Meanwhile, the WHO continued to claim that there was no clear evidence of human-to-human transmission of Covid. Precious data that proved otherwise was only relayed to the WHO when a peer reviewer leaked it.

We need to learn from these mistakes. Researchers, research journals, and databases must share outbreak-related data and manuscripts with the WHO and the international community far more quickly than they have done in the past. After something in the region of 20 million lives lost to Covid, not to mention the massive societal and economic costs, how can our response to the early signs of another possible pandemic still be so toothless? 

The WHO and national governments can—and must—do more than just shrug and hope. The latest scare only underlines how little we have learned from Covid-19—and how vulnerable we remain to another deadly virus that could shut down the entire world.

CORRECTION: A previous version of this piece incorrectly stated that Taiwanese media was the first to report on the outbreak.

Alina Chan is co-author of Viral: The Search for the Origin of Covid-19, scientific adviser at the Broad Institute of MIT and Harvard, and a member of the Pathogens Project task force organized by the Bulletin of the Atomic Scientists.

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