A Timeline of China’s Response in the First Days of COVID-19
The FRONTLINE documentary China’s COVID Secrets tells the story of the beginning of the coronavirus pandemic that would overtake the world, and how Chinese doctors, scientists, health officials and political leaders responded. Here, we highlight some of the key moments in the earliest days of the outbreak.
December 1, 2019 A man in his 70s starts experiencing symptoms. He is later admitted to a hospital in Wuhan, China.
Mid-December, 2019 People begin turning up at hospitals in Wuhan with strange white spots on their lung scans. Many of the cases are traced back to the city’s Huanan Seafood Market, where a variety of live animals are sold. Whether the market is where the virus first leapt from animals to humans is unknown.
December 24, 2019 A sample is taken from a Wuhan Central Hospital patient’s lungs and sent to Vision Medicals, a private company 500 miles from Wuhan that produces a partial genetic sequence of the virus within 48 hours.
December 26, 2019 The sequence from the patient in Wuhan is strikingly similar to the virus that caused SARS, which sickened over 8,000 people and killed more than 700 in 2003.
The lab goes on to inform the Wuhan Central Hospital doctors and the city’s CDC.
December 30, 2019 Around this time, hospitals in Wuhan start seeing dozens of patients with severe pneumonia.
More virus samples are sent to other labs for sequencing. One lab tells Wuhan Central Hospital, mistakenly, that the virus is SARS itself. The lab’s results circulate quickly among the doctors and reach Li Wenliang, an ophthalmologist.
Li forwards a message to a group of doctors with a warning: “Don’t circulate this information outside the group, tell your family and loved ones to take precautions.”
His message goes viral.
The local health commission orders Wuhan hospitals to report new cases directly to them and bars the release of information to the public. The orders leak and spread online.
Word of the virus also reaches Marjorie Pollack, an epidemiologist, in New York. “My reaction was ‘we’re in trouble.’ It was very much a deja vu of what happened with SARS-1.” Her organization, Promed, sends a notification out to around 80,000 subscribers around the world.
December 31, 2019 China’s National Health Commission instructs Wuhan health officials to announce the outbreak. Officials describe the disease to the public as a “viral pneumonia” that’s under control, with no evidence of human-to-human transmission: “We’ve investigated and it has no relationship to SARS.”
The World Health Organization learns about the outbreak from social media and from Promed, not from the Chinese government.
January 1, 2020 Wuhan police reprimand several of the doctors who spread news about an outbreak. Chinese state TV labels them “rumormongers.” Li Wenliang is called to a police station to sign a confession that accuses him of “publishing fictitious discourse” that has “severely disrupted social order.”
The Chinese government disputes that what happened to Li is proof that they were trying to suppress information about the outbreak. They maintain he was merely urged not to spread unconfirmed information.
The WHO requests more information from China’s National Health Commission and begins emergency conference calls.
January 3, 2020 The WHO is told the Chinese government has identified 44 cases of “viral pneumonia” of unknown cause.
January 5, 2020 Labs across China quietly rush to complete a genetic sequence of the new virus, including one run by Professor Zhang Yongzhen, a renowned virologist. In the wee hours of January 5, Zhang obtains a full genetic sequence confirming the virus’s similarity to SARS and its likely transmission between humans.
Virologist Eddie Holmes, who has been working with Zhang on a long-term project, says Zhang is eager to release the sequence as soon as possible. But there’s a problem. “There was an official memorandum that had gone through saying that we were not allowed to do this,” Holmes notes. “So he was put in quite a difficult position.”
China’s National Health Commission had sent secret orders to the labs barring them from publishing their results without authorization.
January 6, 2020 New York Times reporter Sui-Lee Wee writes an article with the headline, “China Grapples With Mystery Pneumonia-Like Illness.”
“I believed that the Chinese government would not think of covering up the way they did during SARS,” Wee says. “And that if the hospitals were overwhelmed, there would be no way to cover that up.”
The Chinese government insists it “took the most comprehensive, rigorous and thorough measures,” and that President Xi Jinping issued epidemic response instructions by January 7th. The details of those instructions have not been made public.
January 8, 2020 A 61-year-old woman travels to Thailand from Wuhan. Temperature checks at the airport indicate she has a temperature of more than 38° celsius (100° F). Publicly, the Chinese government has been saying the outbreak is linked to the Huanan Seafood Market. When Thai health officials talk to the woman, they find that she has had no contact with the market.
“That is really the critical information for us, that the spreading may be generalized in Wuhan,” says Rome Buathong of Thailand’s ministry of public health.
January 9-10, 2020 “The respiratory department became full around 9th or 10th January. I realized that this thing had become big. It was out of control. Then we started to panic,” a health care worker from Wuhan Central Hospital tells FRONTLINE.
“The hospital told us that we were not allowed to speak to anyone,” the worker says. “They wouldn’t even let us wear masks. They said they were afraid of causing panic.”
Some health workers later told Chinese media they tried voicing concerns to the authorities, but local and provincial officials ignored them. FRONTLINE reached out to the local and provincial governments for comment but didn’t receive a response.
January 11, 2020 A representative of the WHO says on Chinese state TV: “It appears that … new cases have stopped after the market was temporarily closed. So the public health intervention has controlled this part of the outbreak. And we can see that there is no clear evidence of sustained human-to-human transmission, which gives us a lot of reassurance.”
The representative praises the “sheer speed of the response in China” and “the extremely rapid investigation.”
Before this, in private, WHO officials had expressed concern about China’s lack of transparency about the virus.
Although Chinese state TV has confirmed the outbreak is a novel coronavirus, virologist Zhang Yongzhen is still prohibited from releasing his full genetic sequencing. His colleague, Eddie Holmes, urges Zhang on. Holmes says, “The sequence release was a key moment because it told people ‘this is the pathogen, this is what it looks like. It’s a real thing. Here it is. And now we can start.’”
Within hours, China’s CDC and National Health Commission share the genetic sequencing they have obtained with the WHO and the public.
January 13, 2020 German scientists publish a toolkit so other countries can test for cases.
Thailand reports the first confirmed case of the new virus outside China — the 61-year-old woman — to the WHO.
Mid-January, 2020 Wuhan hospitals are treating hundreds of patients with respiratory symptoms. The health care worker at Wuhan Central Hospital says: “Every day there were several hundred people with fever arriving at our emergency department. Hundreds every day. I was definitely afraid. I realized that this illness was everywhere.”
Patients begin to die.
Local and provincial authorities only count cases linked directly to the Huanan market, according to leaked documents. And only they are authorized to confirm cases, not doctors.
January 14, 2020 The Chinese government secretly starts ramping up its response.
“So The Associated Press’ global investigative team obtained some documents [that show] that on January 14th, China’s top health official, Ma Xiaowei, he told the country’s public health institutions to prepare for a possible pandemic,” says Associated Press reporter Dake Kang.
Temperature checks show up at train stations and airports around Wuhan. Hospitals across China are told to start getting ready. The government authorizes Chinese state media to say that limited human-to-human transmission of the virus cannot be ruled out.
“These documents reveal that central authorities were very alarmed about the virus by January 14th,” Kang says. “But in public, again, they weren’t really raising the alarm.”
In its official timeline, the Chinese government says that at the time, there was great uncertainty about the new disease and that more research was needed to understand its mode of transmission.
To this point, the WHO has stuck to China’s official line. But at the organization’s first press conference about the outbreak, a WHO official appears to contradict that there is no clear evidence of human-to-human transmission, saying: “So far with the current virus, we have limited human-to-human transmission. But what we are preparing for is the possibility that there will be, there could be.”
A New York Times reporter trying to confirm the comments says the WHO tells her that there has been a “misunderstanding”; there is no clear evidence of human-to-human transmission.
A WHO spokesperson tells FRONTLINE they didn’t intend to suggest at the time that human transmission was definitely happening. WHO scientists were not on the ground, and so the organization couldn’t make the determination officially.
January 19, 2020 Outbreaks appear in other parts of China. Despite the Chinese government’s internal warnings to health officials about a potential pandemic, there is no public lockdown as millions of Chinese prepare to travel for Lunar New Year.
The head of Wuhan’s CDC continues to reassure the public: “The clinical manifestation of patients generally is mild. So we can have the initial impression that the transmissibility of this new coronavirus is not strong. The epidemic is preventable and controllable.”
January 20, 2020 By this day, 198 coronavirus cases have officially been reported.
The Chinese government finally acknowledges that the novel coronavirus is spreading from human to human.
January 23, 2020 There are now 571 official cases of coronavirus in China.
The Chinese government places Wuhan under lockdown.
George Gao, the director of China’s CDC, goes on to tell the media: “Everyone likes to compare it with SARS. But actually, this virus is not as strong as SARS. We’re seeing many mild cases.”
But COVID-19 proves much more transmissible than SARS, and patients overwhelm hospitals.
“It erupted too fast, and then there were just too many people infected,” says the Wuhan Central Hospital health care worker. “Without ventilators, without specific drugs, even without enough manpower, how were we going to save people? If you’re unarmed on the battlefield, how can you kill the enemy?”
China maintains “We have all along been in good communication and cooperation with the WHO” and “China has provided timely information to the world in an open, transparent and responsible manner.”
Watch China’s COVID Secrets in its entirety below.