Why Didn’t the West Pick Up China’s Covid Signals?
“I decided to look retrospectively for publicly available signals that the Hong Kong government was sending about the danger of what (at the time of the first press release that I found) on 31st December 2019 was a “…suspected pneumonia case on the Mainland…”
All governments employ people like me, who, in a different context, constantly scan for signals to match early warning indicators of danger.
Policy makers depend on horizon scanners like me to ensure they can stay ahead of the curve.
The Hong Kong government started publishing early warning signals about “pneumonia cases in Wuhan” on 31st December.
Today I’m publishing excerpts from those press releases below (and here on LinkedIn’s Pulse platform: https://lnkd.in/d6u5kaV)
In their own words, they tell a story of escalating alarm-raising as well as of preparatory measures which have yielded for Hong Kong some of the lowest number of Covid deaths in the world:
In my eyes anyway, these press releases are evidence of transparency, seriousness of purpose and our governments should have been picking these signals up and acting upon them.
Had they done so, thousands, maybe hundreds of thousands of lives would have been saved.
Blaming China for not being transparent enough, when all of our governments appear to have missed 24 days of press releases raising escalating alarm signals about the virus is chutzpah par excellence and a distraction.
We must get better at picking up and acting upon such early warning indicators.
Our civilisation’s persistence depends upon it.
That a press release was published by the government on New Year’s Eve stating
“…Public hospitals heighten vigilance against suspected pneumonia cases on Mainland…”
is an early warning signal par excellence.
I couldn’t find many similar press releases, so that one broke the pattern and indicated something different might be happening.
Before I paste relevant excerpts from these press releases, I want to highlight several issues:
First, we have comprehensive timelines of what the Trump administration was doing throughout this period from great reporting in the Washington Post-Squandered time:
and the New York Times — He Could Have Seen What Was Coming:
Second, by contrast to the Hong Kong government’s immediate transparency, the UK government originally tried to prevent the public knowing about the course of the virus: UK U-turn over plan to stop daily geographical update:
Meanwhile Hong Kong was publishing photographs of its advisory committee meetings.
We still don’t know the names of the people on the UK government’s SAGE scientific advisory group, nor do we have access to much of the data it is using to underpin the options it suggests to the policy makers.
Third, 24th January 2020 is a key date — note below the escalation in press releases from the Hong Kong government that day and the Chief Executive of Hong Kong, Carrie Lam’s press conference the next day.
On 24th January, the world’s fourth most important scientific research journal, the UK based
The Lancet published a paper whose lead author is Hong Kong based Professor Kwok-Yung Yuen (whom Carrie Lam specifically refers to in her 25th January Covid press conference (see below), the transcript of which appears on the Hong Kong government’s website) about a family cluster of Covid-19 patients.
This is the first evidence in a scientific journal of person-to-person transmission. It also provides evidence of asymptomatic transmission of the virus: A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30154-9/fulltext
Fourth, note how the Hong Kong government formed an emergency response committee and published this information. Meanwhile it was reported on April 19th 2020 that UK PM Boris Johnson, reportedly,
“skipped five emergency COBRA meetings on the Coronavirus.”
Fifth, note how on 27th March 2020 before being admitted to an Intensive Care Unit in London with Covid-19, UK Prime Minister Boris Johnson, reportedly,
“admitted to shaking hands of hospital patients before he was diagnosed with the disease.”
The Hong Kong government was urging the mandatory wearing of masks in ALL hospitals from early January, before it even had a confirmed case of Covid-19.
By contrast to these five points, the following press releases by the Hong Kong government, published in English and available worldwide starting on 31st December 2019, provide strong evidence of how a transparent, serious and horizon-scanning government reacted long before the virus was even identified.
These press releases, available on the Internet, constitute an array of early warning signals we might well wonder why our own governments did not act upon and, for example, start building stocks of PPE for medics, enact social distancing measures and save thousands of lives.
I’m agnostic on the origins of the virus — frankly, what happened since January 1st and whether or not our governments are learning lessons going forward about their own failures is much more important to me than trying to cast blame on other countries:
Dec 31st 2019:
“Public hospitals heighten vigilance against suspected pneumonia cases on Mainland…”
Jan 2nd 2020:
“The Government today (January 2) held an inter-departmental meeting to examine the prevention measures adopted in response to the cluster of pneumonia cases detected in Wuhan, Hubei Province … to address public concern and to increase transparency, the Government will daily announce the number of cases meeting enhanced surveillance;…From January 3 onwards, additional thermal imaging systems will be put in place in the Hong Kong International Airport for checking body temperature of inbound travellers from Wuhan. For all boundary control points…”
Jan 3rd 2020:
“…The public is again urged to maintain strict personal, food and environmental hygiene both locally and during travel….According to information from the NHC, a number of viral pneumonia cases with unknown cause have been identified since last December through medical surveillance. Symptoms were mainly fever while a few had presented with shortness of breath….Epidemiological investigations revealed that some patients are business operators at a local seafood market in Wuhan. For the time being, no obvious human-to-human transmission has been observed and no healthcare workers have been infected. While the causative pathogen and cause of infection are still under investigation, influenza viruses, avian influenza viruses and other common respiratory diseases such as adenovirus have been ruled out as the cause… In response to the cluster of pneumonia cases in Wuhan, the CHP has enhanced surveillance since December 31 last year…”
Jan 4th 2020:
“…As at noon today (January 4), in the past 24 hours, public hospitals have admitted three patients (one male and two female), who have been to Wuhan in the past 14 days and presented with fever and respiratory infection or pneumonia symptoms, aged 4–50…”
Jan 4th 2020:
“Serious Response Level activated in public hospitals…On personal protection equipment, such as surgical mask and N95 mask, the current stockpile is adequate for three months’ consumption…”
Jan 4th 2020:
“The Hospital Authority (HA) spokesperson today (January 4) announced the activation of the Serious Response Level in public hospitals with immediate effect…”
Jan 4th 2020:
“The Government today (January 4) launched the Preparedness and Response Plan for Novel Infectious Disease of Public Health Significance (The Plan)…”
Jan 4th 2020:
Preparedness and Response Plan for Novel Infectious Disease of Public Health Significance (2020)
Jan 5th 2020:
“Centre for Health Protection (CHP) of the Department of Health (DH) provides latest information on cluster of pneumonia cases in Wuhan… According to information from the NHC, a total of 59 viral pneumonia cases with unknown cause were reported as at 8am today. No fatal cases have been recorded. All patients are receiving treatment in isolation…Among the 59 cases, the earliest and most recent cases had onset of illness on December 12 and December 29 last year respectively…”
Jan 6th 2020
“Government convenes Steering Committee meeting to prevent novel infectious disease (with photo)…Chairing the meeting, Professor Chan said, “Currently, no serious pneumonia case related to Wuhan has been detected in Hong Kong, but the cluster of viral pneumonia cases in Wuhan can be regarded as a ‘Novel Infectious Disease of Public Health Significance’. Upon risk assessment, the Government officially activated the Serious Response Level, the second tier of the three-tier response level system, on January 4…”
Jan 6th 2020:
“As at noon today (January 6), in the past 24 hours public hospitals had admitted six patients who have been to Wuhan in the past 14 days and presented with fever, respiratory infection or pneumonia symptoms, including a male patient and a female patient who had attended a general practitioner and a private hospital respectively… “The patients concerned had not visited wet markets in Wuhan before the onset of symptoms. All of them are in stable condition. The HA will keep monitoring the patients’ conditions and provide appropriate treatment,” the HA Chief Infection Control Officer, Dr Raymond Lai, said…”
Jan 7th 2020:
“Government to gazette inclusion of “Severe Respiratory Disease associated with a Novel Infectious Agent” as statutorily notifiable infectious disease under Prevention and Control of Disease Ordinance…Since the causative pathogen is still unknown, the prevention work focuses on identifying cases with possible exposure to the high-risk area, i.e. Wuhan, and promptly carrying out public health measures to prevent the spread of disease to Hong Kong. “The Mainland health authorities are still investigating the causative pathogen of the disease. Once a specific infectious agent related to ‘Severe Respiratory Disease associated with a Novel Infectious Agent’ is identified, the name of the disease in Schedule 1 will be suitably revised…According to announcements from the Mainland health authorities, a number of viral pneumonia cases with unknown cause related to a seafood wholesale market in Wuhan have been identified since December 2019 in Wuhan, Hubei Province…”
8th Jan 2020:
A bevy of urgent questions of the Legislative Council are answered by the authorities, including LC Urgent Question 1:
“…So far, investigations by the Mainland authorities found no evidence of definite human-to-human transmission and no healthcare workers have been found infected. While the causative pathogen and cause of infection are still under investigation, respiratory pathogens such as influenza viruses, avian influenza viruses, adenovirus, Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome have been ruled out as the cause…”
Jan 8th:
“… to cope with the suspected cases related to the viral pneumonia with unknown cause in Wuhan…Enhance the HA laboratory service. The rapid test result can be available as early as before 24 hours…Adjust ventilation system to increase fresh air exchange in public hospitals and clinics…The current stockpile of personal protection equipment in public hospitals exceeds 90-days consumption and public hospitals have a total of about 1 400 negative pressure insolation beds…”
Jan 9th 2020:
“….According to information from the NHC, the Mainland’s expert group has preliminarily determined that the pathogen of the cluster of viral pneumonia cases occurring in Wuhan is a kind of novel coronavirus. The relevant Mainland laboratory has detected a novel coronavirus and obtained the whole genome sequence of the virus….The expert group revealed that molecular testing of 15 cases returned positive results for the novel coronavirus, and the virus was also isolated from a sample of a case. Under electron microscopy, the virus showed the typical appearance of coronavirus….Further investigations are also required to determine the source, modes of transmission, extent of infection and countermeasures implemented…The Scientific Committees noted that definite evidence of human-to-human transmission had not been identified in the Mainland so far and no healthcare professionals had been found infected. However, members considered that the available epidemiological information is not sufficient at this stage to reach a conclusion….The Scientific Committees concurred with the assessment of the WHO that the reported link to a wholesale fish and live animal market in Wuhan could indicate an exposure link to animals…”
Jan 12th 2020:
“…According to the information from the NHC, as at yesterday (January 11), 41 patients have been diagnosed to have infection of the novel coronavirus and no new case was reported on January 11. Among them, six patients have been discharged, seven patients are in serious condition and one died, while the remaining patients are in stable condition. A total of 763 close contacts have been identified. All have been put under medical surveillance with 46 of them having completed the surveillance, and no related cases have been detected so far….”
Jan 14th 2020:
“CHP closely monitors confirmed case of infection of novel coronavirus in Thailand…According to information from the health authority of Thailand, the case involved a patient from Wuhan, Hubei Province, in Mainland China, who arrived at Suvarnabhumi International Airport in Bangkok, Thailand, on January 8 and was detected to be having high fever. The patient was subsequently taken to a local medical institute for isolation and management. Laboratory tests there returned a positive result for the novel coronavirus on January 12. The patient has recovered and there have not been additional cases..The WHO said it is working with officials in the Mainland and Thailand following the report. It pointed out that the possibility of cases being identified in other countries was not unexpected and has also issued guidance on how to detect and treat patients infected with the novel coronavirus…”
Jan 16th 2020:
“…Professor Chan said, “Currently, no severe pneumonia case infected with the novel coronavirus has been detected in Hong Kong. The latest investigation results announced by the Mainland authority showed that no clear evidence of human-to-human transmission had been identified so far. However, the possibility of limited human-to-human transmission could not be ruled out. We note that confirmed pneumonia cases infected by novel coronavirus have been detected in other countries…”
Jan 16th 2020:
“…According to information from the health authority of Japan, the case involved a male patient in his thirties who is living in Kanagawa, Japan. The patient, who had earlier travelled to Wuhan, Hubei Province, developed a fever on January 3 and returned to Japan on January 6 and sought medical attention on the same day. He was admitted to a local hospital on January 10 and was discharged on January 15. He tested positive for the novel coronavirus on January 15. According to the patient, he did not visit the Hua Nan Seafood Market in Wuhan but had contact with a pneumonia patient while he was in Wuhan…”
Jan 16th 2020:
“… As at noon today (January 16), public hospitals had reported to the Department of Health (DH) the admission of two patients in the past 24 hours who have been to Wuhan in the past 14 days and presented with fever, respiratory infection or pneumonia symptoms…”
Jan 17th 2020:
“…According to information from the health authority of Thailand, the case involved a 74-year-old female patient from Wuhan, Hubei Province, who arrived Bangkok, Thailand, on January 13 and was detected to be having fever. The patient was subsequently taken to a local medical institute for isolation and management. She was later tested positive for the novel coronavirus. The case is the second confirmed case of infection of novel coronavirus in Thailand…Following confirmed cases of the novel coronavirus infection detected outside China as reported in Thailand and Japan, the World Health Organization (WHO) expected that additional cases in other countries are likely considering global travel patterns. According to the WHO, not enough is known about the novel coronavirus to draw definitive conclusions about how it is transmitted, clinical features of disease, or the extent to which it has spread. The source also remains unknown…”
https://www.info.gov.hk/gia/general/202001/17/P2020011700960.htm
Jan 17th 2020:
“…According to the information from the NHC, as of yesterday, one additional death of the novel coronavirus infection in Wuhan was recorded. The patient, a 69-year-old male, developed symptoms on December 31 last year. His condition deteriorated on January 4 this year and he passed away on January 15. As of yesterday, the total number of novel coronavirus infections in Wuhan remained at 41 cases. Among them, 12 patients have been discharged, five patients are in serious condition and two died…”
Jan 18th 2020:
“…There are currently no patients confirmed as being infected with novel coronavirus in public hospitals…”
Jan 19th 2020:
“…As of January 17, the total number of novel coronavirus infections in Wuhan was 62 cases. Among them, 19 patients have been discharged, eight patients are in serious condition and two died…”
Jan 20th 2020:
“…According to the information from the Beijing Municipal Health Commission, three additional pneumonia cases of novel coronavirus infection were reported in Beijing today. The patients, comprising two males and one female, had either visited or resided in Wuhan. Two of them are in stable condition while one is in critical condition. So far, a total of five confirmed cases have been reported in Beijing…. Meanwhile Shanghai Municipal Health Commission reported its first pneumonia case of novel coronavirus infection today. The case involved a 56-year-old woman coming from Wuhan. She is in a stable condition. Separately, the Health Commission of Guangdong Province reported that an addition of 13 pneumonia cases of novel coronavirus infection were reported today, with eight in Shenzhen, three in Zhuhai and one each in Zhanjiang and Huizhou. The patients comprised 8 males and 5 females. Eleven of them had history of living in or travelling to Wuhan while two had close contacts with confirmed patients. Among the new cases, four are in serious condition and two are in critical condition. No fatal cases have been recorded. So far, a total of 14 confirmed cases have been reported in Guangdong…”
Jan 20th 2020:
“…According to the information from the NHC, from January 18 to 10pm yesterday (January 19), 136 additional pneumonia cases of the novel coronavirus infection in Wuhan were reported…Among the additional cases, 100 are in stable condition, 33 are in serious condition, and three are in critical condition, with one of them having died… As of 10pm yesterday, the total number of novel coronavirus infections in Wuhan was 198 cases… According to the information from the Korea Centers for Disease Control and Prevention, the case involved a 35-year-old female, who came from Wuhan, Hubei Province. She arrived in Korea on January 19 and was detected to be having a fever. She subsequently tested positive for the novel coronavirus upon laboratory testing…The spokesman reminded the public to avoid close contact with persons with fever or respiratory symptoms in countries/areas with possible transmission of the novel coronavirus infection. If it is unavoidable to come into contact with them, put on a surgical mask and continue to do so until 14 days after returning to Hong Kong…”
Jan 21st 2020:
“…The Centre for Health Protection (CHP) of the Department of Health (DH) today (January 21) provides the latest information on the pneumonia cases of novel coronavirus infection detected in the Mainland and Taiwan…According to the notification from the National Health Commission (NHC), 72 additional pneumonia cases of the novel coronavirus infection were reported in Hubei Province yesterday (January 20), including 60 cases in Wuhan…As of yesterday, the total number of novel coronavirus infections in the Mainland was 291 cases, including 270 in Hubei Province, five in Beijing, 14 in Guangdong Province and two in Shanghai. A total of 1 739 close contacts have been identified. All have been put under medical surveillance, with 817 of them having completed the surveillance. As of yesterday, the total number of novel coronavirus infections in Wuhan was 258 cases. Among them, 25 patients have been discharged, and six have died…”
Jan 21st 2020:
“…There are currently no patients confirmed as being infected with novel coronavirus in public hospitals…”
23rd Jan 2020:
“…In light of two confirmed imported cases of novel coronavirus infection in Hong Kong, the Steering Committee formed under the Serious Response Level of the Preparedness and Response Plan for Novel Infectious Disease of Public Health Significance (the Preparedness and Response Plan) convened for the third time today…The Chief Secretary for Administration, Mr Matthew Cheung Kin-chung, said, “We are gravely concerned about the two confirmed imported cases of novel coronavirus infection. Any relaxation is not affordable. Meanwhile, the Government will increase transparency and information dissemination.”… In respect of the supply of masks, the current stockpile of personal protection equipment in the DH and the Hospital Authority (HA) is adequate for three months’ consumption. The Food and Health Bureau and DH are liaising with the suppliers at the wholesale level to ascertain scope for expediting the delivery of and stepping up local supplies…(8) As for travel health advice, members of the public are urged to avoid visiting Wuhan. If it is unavoidable to travel to Wuhan, put on a surgical mask and continue to do so until 14 days after returning to Hong Kong; …”
Jan 23rd 2020:
“… The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 23) investigating the second highly suspected imported case of novel coronavirus infection. The public is again urged to maintain strict personal, food and environmental hygiene both locally and during travel…. The case involved a 56-year-old male who is a Hong Kong resident with good past health. He travelled to Wuhan on January 10 and took the flight (Air China flight CA8279) from Wuhan to Shenzhen on January 19 and then returned to Hong Kong via Lo Wu Control Point by MTR on the same day by himself. He developed fever since January 18 but reported to have no respiratory symptoms…”
Jan 24th 2020:
The Lancet, the world’s fourth most impactful scientific research journals published the first research paper detailing the characteristics of (including community and asymptomatic transmissions) of Covid-19:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30154-9/fulltext
Jan 24th 2020:
“The Scientific Committee on Emerging and Zoonotic Diseases and the Scientific Committee on Infection Control under the Centre for Health Protection (CHP) of the Department of Health today (January 24) convened a joint meeting…The latest recommendation are as follows: The general public is strongly advised not to visit places with community transmission of novel coronavirus…The general public is advised to wear a surgical mask when taking public transport or staying in crowded places. It is important to wear a mask properly, including hand hygiene before wearing and after removing a mask…”
Jan 25th 2020:
“…Hospital Authority activates Emergency Response Level…”
Jan 25th 2020:
“…The CHP is continuing its epidemiological investigations and relevant contact tracing of the five confirmed imported cases in Hong Kong…”
Jan 25th 2020:
“The Chief Executive, Mrs Carrie Lam, held a press conference on measures against novel coronavirus infection on January 25… CEO of HK Carrie Lam: “we reached a critical point on the January 23 when there were two confirmed cases of this novel coronavirus… I understand that this higher level access of an expert advisory panel is also a recommendation from Professor Yuen Kwok-yung [the lead author of the Lancet paper published on 24th Jan] given to me actually earlier today… the difficulties we are facing in dealing with this virus, because the symptoms may be mild or even invisible at the beginning of the onset….” Chief Executive of Hospital Authority: “… Up to 12 pm today, we have accumulative of 305 cases who fulfil the criteria, and all of these cases have history of visiting Wuhan…”.”
