FRONTLINE

S2021 E4 | FULL EPISODE

China's COVID Secrets

The untold story of the beginning of the coronavirus pandemic and how China responded. Chinese scientists and doctors, international disease experts and health officials reveal missed opportunities to suppress the outbreak, and lessons for the world.

AIRED: February 02, 2021 | 1:24:23
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TRANSCRIPT

♪ ♪

♪ ♪

>> (speaking Chinese):

♪ ♪

>> NARRATOR: One year ago, the Chinese government announced

a lockdown in the city of Wuhan.

>> NARRATOR: But for at least 54 days before that,

the virus had been spreading throughout China.

>> I have no doubt that the scientists and doctors

who were on the front lines knew exactly

what they were dealing with.

>> NARRATOR: To this day, the Chinese government insists

that in the fight against COVID-19,

it has acted with "openness, transparency,

and responsibility, and in a timely manner."

>> You can't blame China for coronavirus.

China is a victim, not a source, of this problem.

>> NARRATOR: Over the past year, we've been interviewing doctors,

scientists, experts, and public health officials involved

in the response-- and their accounts paint

a different picture.

>> Every day we would go back and we would ask

for more information.

>> Everyone knew it was human- to-human transmission.

Even a fool would know.

>> It's a perfect storm of multiple failures

happening at the same time.

>> NARRATOR: With leaked documents...

>> NARRATOR: ...and secret recordings...

>> NARRATOR: ...this is the story

of what the Chinese government knew...

>> The first instinct of the authorities

is always to cover up.

>> My guess is that the order to not do anything unusual

came from the very top.

>> NARRATOR: ...and what they told the world.

>> Authorities have reported 27 cases.

>> By the time we knew that it was transmissible

human to human, the cat really was out of the bag.

That was the shot we had, and we lost it.

♪ ♪

♪ ♪

(bats chirping)

>> ...first case here of a severe flu-like illness,

which experts say is a worldwide threat to health.

>> The pneumonia-type bug first appeared in Guangdong province.

Officials there saying the outbreak is under control.

>> ...World Health Organization has issued a global alert...

>> ...virus behind a severe outbreak of pneumonia.

>> NARRATOR: The roots of China's response to COVID-19

go back almost 20 years, to another deadly outbreak.

>> The story does start with SARS,

and it began with the lack of transparency from China.

>> NARRATOR: In November 2002,

an outbreak of Severe Acute Respiratory Syndrome, or SARS,

began in southern China.

The virus is thought to have passed from a bat

into a civet cat and into humans at a market.

It then spread quickly through

southern China's crowded factory cities.

>> Doctors identified there's something unusual happening.

Reported it to the local public health authorities.

It took weeks and months, you know, for them

to take a decisive action.

>> NARRATOR: China's authoritarian government

maintained everything was under control.

>> The immediate response of the Chinese government

was literally to lie and dissemble.

And that caused total confusion for the rest of the world

as this epidemic began to ignite.

>> NARRATOR: Five months into the outbreak,

a Beijing doctor exposed what was really happening.

He revealed there were many more cases

than the government was letting on.

The central government in Beijing now admitted

the scope of the problem.

>> SARS has come to North America.

>> 1,000 people have been quarantined in Hong Kong.

>> Two dead in Canada, and six cases in Europe.

>> NARRATOR: By this time, SARS had spread around the world.

It would ultimately cause almost 800 deaths.

(bats squealing)

In China, the cover-up shook the country.

>> Chinese people became very concerned,

but also angry that the government is not telling them

the truth.

♪ ♪

>> There were stories of kind of people, like, rising up

and mistrusting information.

The damage to the reputation of the party states,

domestically and internationally,

was very heavy, it was felt.

>> NARRATOR: SARS was deadly,

but its ability to spread was limited.

Within eight months, the outbreak was contained.

♪ ♪

>> It was widely seen that the delay by China in reporting

and actually responding was absolutely the reason

why we weren't able to nip it in the bud.

And so the narrative in the global health world was,

China did learn a lesson, they would be better next time,

and that they would be much more responsive and transparent.

>> NARRATOR: Beijing set about making sure that SARS

could not happen again.

♪ ♪

The following year, it began creating what it has claimed

is the largest online infectious diseases reporting system

in the world, run from the Center for Disease Control,

China's CDC.

>> I helped them develop the national CDC.

The CDC that I first visited was in disrepair.

That's completely changed.

And what they did was, they created these various programs--

it was a hundred talents, a thousand talents--

so that people who had been trained in other parts

of the world were recruited back to China

to contribute to the establishment

of new infrastructure for infectious disease surveillance.

>> NARRATOR: One of those recruits was George Gao,

a virologist at Oxford University.

♪ ♪

He became the head of the China CDC in 2017.

♪ ♪

>> Let me tell you how we organize the disease control

and public health in China.

Surveillance.

We have the general, centralized data center within China's CDC.

I will know within hours whether or not we have an outbreak,

you know, even in a small village.

>> NARRATOR: By 2019, Gao was promising

that the country's new online surveillance system

would be able to prevent another outbreak like SARS.

>> So they were indeed confident, right,

that they had the capacity to handle well

a major disease outbreak, should it happen--

that they would be able to nip the crisis in the bud.

(bats chirping)

(horns honking)

>> NARRATOR: On the first of December 2019,

a man in his 70s fell ill.

(coughing)

(busy traffic sounds)

He was admitted to a hospital in Wuhan,

a vast industrial city and the transport hub

of central China.

>> NARRATOR: Unbeknownst to anyone at the time, within days,

up to 200 people were likely already infected

with the coronavirus.

They were walking around undetected,

most likely with mild symptoms or none at all.

Many of the cases would be traced to a sprawling

live animal market which supplied the city's restaurants

and food shops.

♪ ♪

>> Colleagues at the Wuhan CDC,

the Wuhan Center for Disease Control, 2014,

took me there really to say, "Look, this is...

Look at this place, this is the kind of place

where emerging microbes may appear."

And I took lots of photographs, because they are quite jarring.

There were snakes, cats, raccoon dog,

and they were sometimes in individual cages

on the floor and sometimes stacked on top of each other.

>> NARRATOR: After SARS, Beijing had passed a law requiring

markets to maintain sanitary standards,

but it was widely ignored.

>> People will kill animals in front of you.

There's feces, guts, blood, organs lying around,

with wild birds coming down and feeding on it.

You've got thousands of people congregating.

It's a really good place for a virus to spread from one person

to another and get out into the community.

>> NARRATOR: It's not known whether the market was where

the virus first made the leap from animals to humans,

but by mid-December, several people were turning up

at nearby hospitals.

Doctors noticed a pattern--

strange white spots in patients' lung scans.

>> Doctors put two and two together.

If you're in a hospital and you see one pneumonia patient

or even two, you may not think anything untoward is happening.

But the fact that they were seeing it in different locations

meant that-- that cluster meant there was an infectious agent

going around.

♪ ♪

(indistinct voices)

>> NARRATOR: Three weeks after the first illnesses emerged,

doctors at Wuhan Central Hospital took a sample

from a patient's lungs.

They sent it to Vision Medicals,

a private company more than 500 miles away.

Within 48 hours, the company had come up

with a short genetic sequence of the virus.

♪ ♪

A technician at the lab later posted an online account

of what happened next.

Virologist Wang Linfa read the post

before it was removed from the internet.

>> The report back on December 26 is to say,

"Oh, my God, these patients'... samples contain

genetic sequence most relate to bat coronavirus."

>> NARRATOR: The technician then privately told his boss

about the coronavirus over the messaging app WeChat.

♪ ♪

Coronaviruses are a large family of viruses,

which includes SARS and the common cold.

The sequence from Wuhan hadn't been seen before,

but it was strikingly similar to SARS.

>> The person who operated that machine and did the analysis

basically sent a red light flash to the boss of the company.

And the boss says, "This is serious.

Don't send a report out until you're 100% sure."

And a few hours later, basically says, "I'm 100% sure.

This is real."

>> NARRATOR: The lab informed the doctors at the hospital

and the Wuhan CDC.

They also sent the sequence results to the state-run

Chinese Academy of Medical Sciences in Beijing.

Over the coming days, word of a new SARS-like virus was starting

to spread among officials in Wuhan and Beijing.

Several more samples were sent to other labs for sequencing.

None of these results were initially shared

with the international community.

>> So the sequence of a pathogen is really important because that

is what allows people to figure out how quickly the pathogen is

spreading, and to able to create tests to detect the virus.

It's really crucial information for health authorities

in other countries to start detecting this virus.

You know, where is it going?

Is it going to go outside of China?

Is it going to become a pandemic?

Is it human-to-human transmissible?

Of course, you don't want to rush out some information that

could potentially be false and, you know, make everyone think

that, "Oh, this is some other kind of pathogen,"

and somehow misinform people.

>> NARRATOR: Almost a month after the first cases emerged,

hospitals in Wuhan were receiving dozens of patients

with severe pneumonia.

Wuhan's 11 million people were still going about their lives

as normal, unwittingly spreading the virus around the city

and to the rest of China.

♪ ♪

Then a lab in Beijing that had been reviewing a sample

of the virus sent Wuhan Central Hospital some startling results.

This lab had gotten a different result from the previous one.

Rather than a virus similar to SARS,

they said it was SARS itself.

It would turn out the lab had made a mistake,

but the results quickly started circulating among doctors

at Wuhan Central Hospital.

>> This was the first time that the information about

the possibility of this virus was shared,

this was the first time there was documentation,

there was evidence that something is really happening,

and that's being shared publicly.

WeChat groups are like little discussion circles,

there could be hundreds of people in one group.

And it's very, very easy for information to spread,

and it spreads like fire.

>> NARRATOR: At around 5:30 p.m., it reached Li Wenliang,

an eye doctor.

He forwarded it on with a warning:

"Don't circulate this information outside the group.

Tell your family and loved ones to take precautions."

>> He was talking to a group of fellow doctors

from his university when he brought up the problem.

He wasn't trying to go public.

And in the ordinary course of events,

it would have been like a little black mark

on, on a record somewhere.

Instead, he ended up at this kind of crux of, of history.

>> NARRATOR: His message went viral.

♪ ♪

In Wuhan, the local health commission ordered

the city's hospitals to report any new cases directly to them,

and barred them from releasing information to the public.

♪ ♪

Within 12 minutes, the orders were leaked.

They too were widely shared on the internet.

News of an outbreak had escaped.

(sirens wailing in distance)

>> I guess you could say it's the most wonderful

and busiest time of year-- a lot of people, high volume,

are gonna be traveling...

>> NARRATOR: That night, the rumors reached

Marjorie Pollack, an epidemiologist with ProMed,

an organization which sends out alerts on disease outbreaks.

>> I checked my email after dinner,

and I had an email from a colleague in Taiwan.

Social media was ripe with lots of chatter going on in Chinese

of an outbreak, and did we know anything about it?

♪ ♪

I was able to monitor the Weibo posts,

and it was just going wild.

My reaction was, "We're in trouble."

It was very much a déjà vu of what happened with SARS-1.

So put together a report to go out as what we would call

an emergency post, getting it out as soon as possible.

♪ ♪

>> NARRATOR: It went out to around 80,000

subscribers worldwide.

(siren wailing in distance)

>> It's already the new year in much of the world,

and here in New York, they're getting ready

for the most famous New Year's spectacle,

the ball drop in Times Square.

>> NARRATOR: Peter Daszak, head of a New York-based

infectious disease research organization,

contacted Marjorie Pollack with more news.

>> I got hold of her on New Year's Eve.

And as the champagne was getting warm,

we realized something really serious was going on in China.

We had it from a good source that this was a coronavirus,

and that it was 20% different to SARS.

So we knew that SARS was pretty good at transmitting

from person to person.

We knew it had a ten-percent mortality rate.

That's a huge red flag.

♪ ♪

And really knew something was wrong when every single

senior person that I was trying to get ahold of in China

was busy.

I sent a really long text to George Gao,

who's head of the CDC.

I offered to send a team out there to come out there

and do anything to support him,

and I got the shortest response ever from George,

which was, "Happy New Year!"

>> NARRATOR: But George Gao did contact virologist Ian Lipkin

with information about the virus.

This is the first time Lipkin has publicly recounted details

of their conversation.

>> I was in a restaurant waiting to ring in the New Year.

And I got a call on WeChat, and it was George Gao.

He'd identified the virus, it was a new coronavirus,

and that it was not highly transmissible.

Well, this didn't really resonate with me,

because I'd heard about many, many people who'd been infected.

I think he was just wrong.

You know, I don't think he was duplicitous,

I think he was just wrong.

He should have released some sequences and said,

"This is what we know, these are the sequences we have."

My view is that you get it out.

That's the way we do it,

because this is too important to hesitate.

(cheers and applause)

>> Ten, nine, eight, seven,

six, five, four, three, two, one!

(cheers and applause)

("Auld Lang Syne" playing)

>> NARRATOR: George Gao did not respond

to our interview requests.

He has told Chinese state media that the sequences

were released as quickly as possible,

and that he never told the public there was no

human-to-human transmission.

>> News of the possible outbreak had actually spread far beyond

Wuhan by late December, and that suddenly,

there was this increasing kind of pressure,

because the outside world was looking,

but that's a dual-edged sword in China.

Because on the one hand, the outside world looking

can create pressure to act.

The outside world looking can also create pressure

to cover up.

(news theme playing)

>> Viral pneumonia has hit Central China's Wuhan City.

Authorities have reported 27 cases in total,

seven of which are critical.

>> NARRATOR: The National Health Commission now instructed

Wuhan health officials to announced the outbreak.

(reporter speaking Chinese)

>> NARRATOR: The news was aired on state-run TV.

>> The patients are reported to have worked

at a local seafood market.

>> NARRATOR: But the officials played it down,

describing it only as a "viral pneumonia"

that was under control.

>> (speaking Chinese):

>> NARRATOR: They reassured the public

that there was no evidence of human-to-human transmission,

and closed the market where they maintained

many cases had originated.

(indistinct chatter)

>> The first instinct of the authorities

is always to cover up.

One of the key values of the Chinese Communist Party

for the last 40-odd years has been stability.

(people chanting slogans)

Avoidance of what they see as chaos,

the dangers of revolution, overthrow...

But the party's also very concerned about the idea

that whole populations might freak out.

And that might result in mass shortages or people being

crushed to death trying to flee somewhere.

That urge to control, that belief that the public can't be

trusted, is also very kind of ingrained.

>> The definition of stability keeps getting escalated

as the ability of the Chinese government to monitor

absolutely everything improves.

Even some of the thoughts and speeches of Chinese citizens,

they are now seen as signs of instability.

Increasingly, even in WeChat, which is a private platform,

that kind of, you know, so- called deviant speech would be

punished with administrative detention or suspension

of, of accounts.

>> (speaking Chinese):

>> NARRATOR: On January 1, the Wuhan police dealt with

the doctors who'd spread the news of an outbreak.

On state TV, they were labeled "rumor-mongers"

and "internet users."

Several were given official reprimands by the police.

The news was widely covered on national television.

(all speaking Chinese)

(voices overlapping)

♪ ♪

>> NARRATOR: The eye doctor Li Wenliang,

whose post had gone viral, was called to a police station,

where he signed a confession.

The Chinese government has disputed that what happened

to Li is evidence they were trying to suppress

news of the outbreak.

They say he was simply being urged not to spread

unconfirmed information,

and that all countries have strict rules

on the confirmation of infectious diseases.

But the clampdown extended beyond doctors.

Chinese journalists were now subject to specific

censorship instructions, and key words began to disappear

from the internet.

>> When I first started seeing the reports on December 31,

doctors from inside were describing it as SARS.

And so, you know, I started searching "Wuhan SARS"

to see what the discussion was online.

And I couldn't find anything.

You know, you had that standard term "that relevant search term

is blocked," which is not a surprise,

because the government obviously wants to keep things stable.

I'm pretty sure they did not want any comparison to SARS.

They wouldn't want a panic to ensue because of that.

>> NARRATOR: But by now in Beijing and Wuhan,

top government officials were confronting evidence

that they were dealing with something potentially serious,

a novel coronavirus.

♪ ♪

>> So, let me tell you what international law requires.

If the government knows about, um, a novel infection that meets

the criteria within

the International Health Regulations--

and a novel coronavirus by definition meets

those criteria of, of a potential

public health emergency of international concern--

the government is obliged by law to report that

to the World Health Organization within 24 hours.

So it was reportable-- the failure to report clearly was

a violation of the International Health Regulations.

>> NARRATOR: The World Health Organization first learned about

the outbreak not from the Chinese government,

but from social media and a ProMed post.

On January 1, its incident management team began a series

of emergency conference calls.

>> I remember sitting on the floor in the living room

of my sister's house at 3:00 in the morning on those calls,

with the aim of, you know,

really understanding the situation.

We had the assumption initially that this may be something new,

that it may be a new coronavirus.

And as a respiratory pathogen,

for us, it wasn't a matter of if, you know,

human-to-human transmission was happening,

it was, what is the extent of it and where is that happening?

>> NARRATOR: W.H.O. officials requested more information

from China's National Health Commission.

It was two days before they heard back.

What they were told was vague--

there were "44 cases of viral pneumonia of unknown cause."

>> The country has an obligation

to answer W.H.O.'s questions

honestly, fully, and transparently,

and I don't think that that happened entirely.

Any time you get an emerging disease outbreak,

it's a little bit of chaos at the beginning,

and also a little bit of disbelief.

But having said that, it's hard, knowing what happened at SARS,

why W.H.O. was not informed straightaway.

Once you report to W.H.O., it's open to the world.

You start to get travel and trade restrictions

placed upon you.

China had the memory that they lost a lot

of economic productivity and travel and tourism

and trade during SARS.

And so I think China's view was that, um, it, it wanted

to handle this, pretty much, and that it was going to,

um, it didn't want outside interference.

>> NARRATOR: The Chinese government refused

multiple interview requests.

Instead, it shared a document called

"Reality Check of U.S. Allegations Against China

on COVID-19."

The document states, "We have all along been

in good communication and cooperation with the W .H .O.,"

and, "China has provided timely information

to the world in an open, transparent,

and responsible manner."

The National Health Commission now had a team of scientists

and officials on the ground in Wuhan

investigating the outbreak.

And labs across the country were secretly racing to map

the complete genetic sequence of the new virus.

One of those labs was run by a renowned virologist in Shanghai,

Professor Zhang Yongzhen.

>> Professor Zhang, he's a very, very friendly, passionate,

extraordinarily hardworking scientist.

I've been working with him since 2012, and we essentially use

genomic technology to try and understand virus evolution

and diversity-- just how many viruses are there,

how big is the total universe of viruses, the virosphere?

>> NARRATOR: Virologist Eddie Holmes and Professor Zhang

were in the middle of a long-term project

on respiratory diseases at Wuhan Central Hospital

when the outbreak began.

On the 2nd of January, lung samples from infected

Wuhan patients were sent by high-speed train

to Zhang's lab.

At around 2:00 a.m. on the 5th of January, a breakthrough:

Zhang had obtained the full genetic sequence of the virus.

>> And I was driving to breakfast and he called me

on the car phone.

His team had worked very hard, and so he was very proud,

obviously, of the work they'd put in.

On that very day, he was, he was working to try

and get information released as soon as possible,

so the rest of the world could see what it was

and so that we could get, you know,

we could get diagnostics going.

>> NARRATOR: It was important confirmation that the virus

was very similar to SARS, and therefore likely

transmissible between humans.

Zhang's office immediately wrote

to the National Health Commission,

advising preventative measures in public places.

Zhang and Holmes wanted to make the sequence public right away--

but they couldn't.

>> There was an official memorandum

that had gone through, saying that he, we were,

we were not allowed to do this.

And so he was put in, he was put in quite a difficult position.

>> NARRATOR: Two days earlier, the National Health Commission

had sent out secret instructions to laboratories,

forbidding them from publishing their results

without authorization and requiring them to destroy

or hand over their samples.

The health commission's orders were later leaked.

Four other Chinese labs also obtained

the full genetic sequence of the virus.

They, too, were forced to sit on their findings.

>> I mean, the notice says very clearly that you cannot spread

or disseminate any information about this pathogen

to the outside world.

And what that effectively did was, it silenced

individual scientists and laboratories from talking about

this outbreak, from revealing information about this virus,

and potentially allowing word of it to leak out

to the outside world and alarm people.

The question then naturally becomes,

why would you do something like that?

Why would you order people not to talk about this virus?

And it's difficult to say exactly what the motives were

behind that order.

From all indications, from the way they behaved

in early January, they seemed to be really treating this

as a slow-moving virus.

>> NARRATOR: Doctors were now dealing with more and more

people turning up sick in Wuhan's hospitals.

Health workers had been forbidden from talking

to the international media without authorization.

But one agreed to speak.

This is the first time a health worker

from Wuhan Central Hospital has talked

to international journalists about what was happening

in those early days of the outbreak.

We are protecting the person's identity

and using an actor's voice.

>> I began to suspect there was human-to-human transmission

around the 5th or 7th January.

There were so many people who had a fever.

The respiratory department became full around

the 9th or 10th January.

I realized this thing had become big.

It was out of control.

Then we started to panic.

>> NARRATOR: But on state television,

a representative of the government team

investigating the outbreak maintained

it was a viral pneumonia.

>> (speaking Chinese):

♪ ♪

>> Everyone knew it was human- to-human transmission.

Even a fool would know.

So why say there is no human transmission?

This made us very confused.

Very confused, and very angry.

The hospital told us that we were not allowed to speak

to anyone-- they wouldn't even let us wear masks.

They said they were afraid of causing panic.

I thought the leaders were stupid.

>> NARRATOR: Around Wuhan doctors and nurses

began getting sick.

A sign of human-to-human transmission.

Some health workers later told Chinese media they tried voicing

concerns to the authorities but local and provincial officials

ignored them.

>> I think the main concern is that,

what if it is a false alarm, right?

That if there's chaos and instability,

you know, people panic,

then they would look bad in the eyes

of the central leaders, you know?

That is not good for their, uh, personal careers.

>> (singing Chinese national anthem)

>> NARRATOR: On January 6, city and provincial officials

began 12 days of annual political meetings in Wuhan.

(anthem continues)

>> There are indications that Wuhan city officials did not

want information about this outbreak to really spread,

because, you know, they really want things to go as smoothly

as possible to make themselves look good.

It also could have been an order from the top down,

where they were saying, you know, basically,

"Get this under control, but don't tell anyone,

because we don't want to alarm anyone."

It's very possible that there was kind of a systemic failure.

It's a perfect storm of multiple failures happening

at the same time in different parts

of the government bureaucracy.

>> NARRATOR: We asked the local and provincial governments

for comment but did not receive a response.

>> (speaking Chinese)

>> NARRATOR: The Chinese central government insists

it "took the most comprehensive, rigorous, and thorough measures,

and that by January 7, Xi Jinping had issued

epidemic response instructions.

>> (speaking Chinese):

>> NARRATOR: Though the details of those instructions

have not been made public.

As the virus continued to spread,

the world outside Wuhan largely remained in the dark

about what was going on.

>> I reported the first story, which was on January 6.

The two people I spoke to in Wuhan who were sick told me,

"Oh, you know, we're fine. No one in our family is sick ."

And so I thought, "Oh, okay, it's probably some, you know,

pneumonia-like illness that's not going

to sweep around the world."

I also spoke to a couple of experts.

They also thought that it was not going to be

that significant.

Health workers were not getting sick

and no one had died at that point.

I believed that the Chinese government wouldn't,

um, would not think of covering up the way they did during SARS.

And that if the hospitals were overwhelmed,

there would be no way to cover that up.

♪ ♪

I do wonder whether my first report, you know,

conditioned people to think that this was

not such a big deal after all.

♪ ♪

>> (speaking Chinese):

>> NARRATOR: Across China, most people were unaware

of what was happening in Wuhan.

Zhang Hai was making plans to take his 76-year-old father,

Zhang Lifa, back to the city.

>> (speaking Chinese):

>> NARRATOR: Zhang Hai checked his father

into the People's Liberation Army Hospital

in central Wuhan to have his broken leg operated on.

>> (speaking Chinese):

>> NARRATOR: By January 8, it's estimated more than 6,000 people

had been infected by the virus.

The Chinese New Year was just over two weeks away.

15 million people were expected to travel out of Wuhan alone

during the holiday.

One of their top destinations abroad was Thailand.

Publicly, the Chinese government was still saying that cases

were linked to the Huanan Market,

and there was no evidence of human-to-human transmission.

But Thai health officials were skeptical.

>> China said that there is no evidence that the disease

has human-to-human transmission, but we all know very well

that for, for the pneumonias, usually there will be some,

some human-to-human transmission.

So that is what we prepared for.

So we started screening the passengers from Wuhan.

♪ ♪

>> NARRATOR: Bangkok's main airport began temperature checks

on all passengers from Wuhan,

not just those who had been to Huanan Market.

>> (speaking Thai):

♪ ♪

>> NARRATOR: On January 8, a 61-year-old woman from Wuhan

arrived for a tour of Thailand.

>> NARRATOR: When Dr. Rome interviewed the woman,

he discovered an alarming detail.

>> NARRATOR: Thai health officials took a sample

from the woman.

They wanted to be sure it was the same illness

as the one spreading in Wuhan.

♪ ♪

The sample was sent to an expert on coronaviruses.

>> NARRATOR: She quickly identified four short

genetic sequences, but it wasn't quite enough.

>> NARRATOR: Officials at the World Health Organization

were also waiting for more information on the virus.

Publicly, the W.H.O. had been echoing China's official

position that it was a viral pneumonia.

But behind closed doors, something else was going on.

>> The W.H.O. starts to get concerned

because they're starting to hear, you know,

the Chinese authorities know more.

Oh, they had sequenced the virus.

They've identified what kind of virus it is,

but they don't know what's going on.

And that we know because the Associated Press obtained

some recordings of internal meetings by W.H.O. officials.

>> NARRATOR: The Associated Press shared some of

the leaked recordings with "Frontline."

They show that officials were frustrated

at China's lack of transparency.

>> NARRATOR: Dr. Mike Ryan, who was overseeing the response

to the emerging outbreak, was worried

that the W.H.O. would be accused of failing to warn the world.

♪ ♪

>> The really pivotal moment comes around January 8, when,

you know, they hear that "The Wall Street Journal"

is about to report that the Chinese authorities

have identified a novel coronavirus,

and this is information that the Chinese authorities

have not told the W.H.O.

>> NARRATOR: The W.H.O. was now getting critical information

from the media, not from the Chinese government.

Over the next 48 hours, Mike Ryan had a series of meetings

with colleagues to discuss the mounting crisis.

♪ ♪

>> Those concerns are not something they ever

aired publicly.

And instead, they basically deferred to China, they said,

"Oh, you know, China says that there's this number of cases."

>> NARRATOR: The next day, a W.H.O. representative

went on Chinese state television.

>> It appears that the cases have stopped, um,

new cases have stopped after the market

was temporarily closed.

And we can see that there is no clear evidence

of sustained human-to-human transmission.

The sheer speed of the response in China,

the quality of the closure of the hospital--

the market, the extremely rapid investigation,

shows the increase in capacity that China has, has acquired.

>> NARRATOR: The W.H.O. never publicly accused China

of hiding information or breaking

any of the International Health Regulations.

We asked them why they didn't take a tougher public line.

>> We have public discussion about the information

that we have, we also have very direct conversations

with countries privately,

which are very strong in the sense of the information

that we need.

But we are the United Nations organization on health,

and we are, we have a diplomacy that we use,

because this is really important that we work with

all member states, we work with everyone everywhere.

Every day, we would go back and we would ask

for more information, and we would receive

information every day.

Was it enough every single day?

No, but I could say that for every country that we've dealt

with in every outbreak that we have dealt with.

♪ ♪

>> W.H.O. was caught in a really difficult bind.

It could have publicly challenged China, or--

and this is what W.H.O. decided that it would do--

to actually work with China behind the scenes,

to try to coax them to cooperate.

You know, time and time again, there have been countries

that have violated

the International Health Regulations.

And director generals in succession

really never called out a country.

>> Ultimately, the impression that the rest of the world got

was just what the Chinese authorities wanted,

which is that everything was under control,

which, of course, it wasn't.

♪ ♪

>> NARRATOR: Six days had passed since Shanghai virologist

Zhang Yongzhen had obtained the full genetic sequence

of the virus.

By now, Chinese state media had announced

it was a novel coronavirus.

But Zhang was still prohibited from publishing his data.

>> (speaking Chinese):

>> Once the Chinese authorities confirmed it was a coronavirus,

at that point, it seemed absolutely ridiculous

that we couldn't release the data.

It was untenable that we were sitting on this information

and not letting it go out-- it seemed wrong.

He was very stressed because he was under great pressure.

He's a Chinese citizen and he's very, he's a very proud

Chinese citizen, he doesn't want to do things

that he thinks will be wrong for his country.

On the Australian morning of January 11,

Zhang and I were talking on the telephone,

and he was on a plane flying between Beijing and Shanghai.

I said that we need to release it, it's now, it's now

or never, really, we have, we have to do this,

and he said okay.

So he sends me this email with a file with the sequence in.

And I contact a colleague in Edinburgh,

Professor Andrew Rambaut,

and he established a website called Virological,

which is used for rapid dissemination of data.

It's, like, 1:00 in the morning in the U.K.,

and we need to write, like, some text saying what it is

and where it comes from.

My hands were kind of, I remember, I was sort of shaking

as I was pressing the button.

I could almost hear the hands of the clock ticking.

So then we posted it on Virological,

and I put a tweet out saying,

"Here's the first genome sequence."

So that bit was done extremely quickly.

I just felt the weight of pressure

just to get this out there.

♪ ♪

The sequence release was a key moment, because it told people,

"Right, this is the pathogen, this is what it looks like,

it's a real thing, here it is, and now we can start."

♪ ♪

>> NARRATOR: The release of the sequence forced Beijing's hand.

Within hours, China's CDC and National Health Commission

made public the genetic sequences they'd obtained

and shared them with the W.H.O.

The international community was now able to act.

On January 13, German scientists published a toolkit

for a test so other countries could check for cases.

>> A Chinese tourist in Thailand is the first confirmed case

of the new pneumonia virus outside China.

>> Researchers in the U.K. then quickly did modeling to figure

out, "Oh, you know, if there's these cases that are showing up

outside of China, how many people are actually infected

in Wuhan?"

So what they found was pretty alarming.

It showed that there were probably thousands of people

infected in Wuhan.

>> NARRATOR: After the release of the sequence,

Zhang's lab was temporarily shut down

for what the authorities called "rectification."

In the Chinese government's official account

of how it responded, there's no mention of Zhang's role.

They say that it took time to study

and understand the virus, and that they "wasted no time"

in releasing the sequence to the W.H.O.

Wuhan's hospitals were now treating hundreds of patients

with respiratory symptoms.

The health worker at Wuhan Central

told us the emergency room was filling up.

>> 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.

>> NARRATOR: Patients were starting to die.

>> Around me, one by one, my colleagues

were becoming infected.

All of us were definitely scared.

♪ ♪

>> NARRATOR: Although there were now hundreds of sick patients

across Wuhan, they weren't being logged

in the CDC's much-touted reporting system.

The official case count had in fact been revised down to 41.

According to leaked documents from the city health commission

and Wuhan Central Hospital, local and provincial authorities

were suppressing the numbers.

They were only counting cases linked directly

to the Huanan Market.

And only they not the doctors

were authorized to confirm cases.

>> At the level of the hospital,

we could not confirm a diagnosis.

And I don't know what level could actually

confirm the diagnosis.

So to say there were 41 confirmed cases

I don't think is incorrect.

But if you're talking about suspected cases,

I guess that at that time,

there were already hundreds and hundreds.

♪ ♪

>> NARRATOR: During this period, the National Health Commission's

scientists on the ground in Wuhan were gathering

extensive data about the outbreak,

and preparing a paper on their findings.

>> At the very beginning of January, the central government

had dispatched a team of leading infectious disease experts

from the Peking University School of Medicine--

it's kind of like the Harvard Medical School of China--

as well as from other leading universities.

And so they arrived in Wuhan,

they began to look at the clinical data

that they had gathered up to January 2.

>> NARRATOR: The data covered all 41 official cases

hospitalized by January 2.

♪ ♪

It was an alarming picture.

It turned out only two-thirds of cases were linked

to the Huanan Market.

The first case had no link to any of the others.

There were clusters of cases within families.

The National Health Commission scientists concluded the virus

could have acquired the ability

for "efficient human-to-human transmission."

And that there was potential for a pandemic.

>> They had been working on this paper since early January,

and so they would have submitted an internal version of the paper

to a senior official in China.

>> NARRATOR: The Chinese government did not answer

our questions about whether anyone had signed off

on the paper.

But the scientists it had appointed

ended up sending a draft to the prestigious "Lancet"

medical journal in London.

>> When I read through that paper, I had nothing but fear,

because the severity of the disease was shocking.

I mean, these patients, they were rapidly deteriorating

into multi-organ failure,

admission to intensive care unit, a high mortality.

The virus was triggering this massive inflammatory explosion

which was damaging the organs of their bodies,

and when you see the severity of the illness combined

with the signal of the risk of a global pandemic?

Fear.

>> NARRATOR: Horton said he held off publishing the paper

while it was getting peer-reviewed.

In the meantime, Beijing did not make public

its team's findings-- including that the virus was likely

being transmitted from human to human.

>> I think that what was happening was

that very difficult interface between the message coming

from the scientists,

and the politicians who are trying to manage that message

internally for domestic security and externally in terms

of its international relations,

and I think that's where the block took place.

But I have no doubt that the scientists and doctors who were

on the front lines knew exactly what they were dealing with.

♪ ♪

>> NARRATOR: In Beijing, the government secretly started

to ramp up its response.

Xi Jinping issued new instructions on the outbreak.

They were passed down to the country's local and provincial

health departments.

♪ ♪

>> So the Associated Press's global investigative team

obtained some documents...

(electronic device screeching)

...that shows that on January 14, China's top health official,

Ma Xiaowei, he told the country's public health

institutions to prepare for a possible pandemic.

>> NARRATOR: The documents contained warnings

that the outbreak was likely to develop

into a major public health event.

China's most severe challenge since SARS.

>> They were saying things like, you know, clustered cases means

that human-to-human transmission is possible.

They were saying things like because of upcoming travel

for China's biggest holiday of the year,

the Spring Festival, means that this virus

could be spreading widely.

>> NARRATOR: At train stations and airports around Wuhan,

temperature checks began appearing.

Hospitals across the country were told to start preparing.

♪ ♪

The government did not announce these new emergency measures

to the public.

♪ ♪

But it did authorize state media to say

that limited human-to-human transmission

could not be ruled out.

>> (speaking Chinese):

>> (speaking Chinese):

♪ ♪

>> These documents reveal that central authorities were

very alarmed about this virus by January 14.

But in public, again, they weren't really

raising the alarm.

They say things like, in the run-up to the two big meetings

that China has every year-- political meetings--

"We have to maintain social stability."

There's a big emphasis on that, and that really points

to the authorities not wanting to freak people out

for political reasons.

>> NARRATOR: 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.

♪ ♪

The W.H.O. called its first press conference

on the outbreak.

>> So, good morning, colleagues, thank you for the opportunity

to be here today with you.

So just to provide a little bit of background

about what coronaviruses are and...

>> NARRATOR: Publicly, the W.H.O. had been sticking

to the official Chinese line that there was no clear evidence

of human-to-human transmission.

But in front of the media, the agency's coronavirus expert

appeared to contradict that.

>> 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.

That was my first press conference I've ever done.

I presented the situation as I understood it,

and as we understood it from the data,

and as it relates to the guidance

that we want to put out.

And so when you have a respiratory pathogen,

of course there would be human-to-human transmission,

it's just, where is that happening

and what is the extent?

>> NARRATOR: News spread fast that the W.H.O. had confirmed

human-to-human transmission.

>> The first report came out from Reuters.

They sent out a news alert

that the W.H.O. said that there was limited

human-to-human transmission.

So I quickly sent an email to Geneva saying,

like, "Can you confirm this?" and started writing the story.

You know, that the W.H.O. had identified this as a virus

that can spread easily among humans.

And then they said, "Oh," they sent me an email to say,

"Oh, it was a misunderstanding.

The preliminary investigations conducted by the authorities

have found no clear evidence of human-to-human transmission.

There has been no evidence of limited

human-to-human transmission."

>> NARRATOR: In a statement, a W.H.O. spokesman told us

they never intended to suggest that there was definitely

human-to-human transmission happening.

Despite the mounting evidence,

the spokesman said W.H.O. scientists were not

on the ground, so couldn't make that determination officially.

>> We rely on the information that is provided to us.

There's always more information that we need-- always.

Things were happening very, very quickly, um,

and we were utilizing the information that we have,

and we always go back to the countries to gather

more information, and China was no different.

>> I do appreciate that it's early on in the pandemic,

and there was this, you know, there was what we call

the fog of war.

People are trying to understand what's happening,

and you don't want to put out information

before you don't really know what's happening.

But it made a lot of us think, me included, that, you know,

this wasn't such a big deal after all.

So I just left it at that and scrapped the story.

(clock ticking)

>> NARRATOR: Outbreaks had now begun in other parts of China.

People were turning up in hospitals in the major cities

of Beijing, Shanghai, and Shenzhen.

♪ ♪

Chinese New Year was approaching and the country was on the move.

>> What typically happens is that in the run-up

to the Chinese New Year, close to 300 million migrant workers

leave the cities where they worked

to return to their hometowns to celebrate the Lunar New Year

with, with their parents and loved ones.

>> NARRATOR: The Chinese government had already issued

its internal warnings to health officials

about a possible pandemic.

But they did not order a lockdown.

>> We don't know why there was this delay.

I think the Chinese government was coming up with a plan

of how to deal with the pandemic.

My favorite speculation, I guess, is that they made

the decisions to hide the news so that the Spring Festival

migration can proceed without any hiccups, without any panics.

There's actually a very decent public health reason.

If they had announced a lockdown,

that would have meant that hundreds of millions

of migrant workers would have been trapped

in the major cities,

which would have great implications

for both public health, but also for stability.

♪ ♪

>> NARRATOR: In Wuhan, life continued as normal.

There was a college careers event, performances,

and a mass banquet attended by thousands.

>> (speaking Chinese):

>> It was unnecessary.

You know, the Wuhan government could have canceled the banquet.

The reporters talked to community workers,

and they were afraid, and they tried to convince

district-level officials to cancel the banquet,

but the district-level officials would not do it.

They refused to do it.

My guess is that the order to not do anything unusual came

from the very top, you know,

some very senior-level officials in Beijing.

>> NARRATOR: On January 19, the head of the Wuhan CDC

was still reassuring the public.

>> (speaking Chinese):

♪ ♪

>> NARRATOR: Neither Wuhan officials nor the Chinese

central government have specifically answered

for why they were still downplaying the outbreak

and allowing these mass gatherings and travel.

♪ ♪

By January 20, it's estimated that more than 80,000 people

in the country were infected.

♪ ♪

On state TV, the government finally acknowledged

that the virus was spreading human to human.

♪ ♪

The news was delivered by the revered 83-year-old doctor

Zhong Nanshan.

>> (speaking Chinese):

>> (speaking Chinese):

>> Zhong Nanshan is very respected.

To have him go on CCTV to disclose this,

to be the first person in China to say that this is what

was going on, was jaw-dropping.

And that was when cases started to skyrocket in Wuhan,

and the numbers multiply tenfold very fast.

♪ ♪

>> (speaking Chinese):

>> It was always going to be very difficult to control

this virus from day one.

But by the time we knew that it was transmissible

human to human, I think the cat was out of the bag,

it had already spread.

That was the shot we had, and we lost it.

♪ ♪

>> NARRATOR: At 10:00 a.m. on January 23,

Wuhan was put on lockdown.

>> The city at the heart of the public health crisis in China

is shutting its public transport network.

>> Flights canceled. Trains halted.

Highways blocked by police.

(woman speaking Chinese on loudspeaker)

>> 11 million residents have been told to stay put.

(indistinct chatter)

>> NARRATOR: CDC director George Gao went before the media.

(reporters clamoring)

(speaking Chinese)

♪ ♪

>> NARRATOR: Despite Gao's assurances,

doctors on the front lines were confronting the reality

that COVID-19 was much more transmissible than SARS.

Hospitals were overwhelmed.

(workers speaking Chinese)

(people clamoring)

By one estimate, Wuhan Central Hospital received

over 1,500 patients on a single day.

>> There were some patients who didn't need to die.

There was nothing we could do.

The medical resources were just too tight.

It erupted too fast, and then there were just

too many people infected.

Without ventilators, without specific drugs,

even without enough manpower,

how were we going to save people?

If you are unarmed on the battlefield,

how can you kill the enemy?

I believe that the true history needs to be remembered.

We need to learn the lessons so that this doesn't happen again.

>> NARRATOR: At the Army Hospital in Wuhan,

Zhang Hai's father, Zhang Lifa, was recovering

from his leg operation.

But he'd developed a fever.

>> (speaking Chinese):

(air hissing)

>> NARRATOR: The Chinese government says fewer

than 5,000 of its citizens have died from COVID-19,

but many outside experts say the number is likely much higher.

Among the dead: eye doctor Li Wenliang,

who had first raised the alarm about an outbreak.

Around the world, the death toll is over two million

and still climbing.

>> Exactly one year ago today, the first COVID case

in this country was confirmed.

By next month, more than half a million lives

could be lost to the virus.

>> One person now dying every six minutes.

♪ ♪

>> January 20 is the dividing line.

Before that, the Chinese could have done much better.

After that, the rest of the world should be really

on high alert and do much better.

>> I don't think it's clear right now exactly how history

is going to view this pandemic.

If the Chinese authorities had acted earlier,

would it have made a difference?

I think that's the key question.

And I don't think there's an answer to that right now.

It might have been a case where it was already too late

by the time we realized that this virus was spreading.

But I think what we can say, based on what we know right now,

it's clear that there were mistakes that were made,

there were clear delays, and many people did suffer

the consequences.

>> NARRATOR: The Chinese government continues to defend

its response to the outbreak.

>> (speaking Chinese):

>> If the great coronavirus pandemic of 2020

teaches us anything, it teaches us that we absolutely

have to have the kind of, you know, open sharing

among scientists and governments about all information.

We're all in it together.

>> What we need is early warning and work together,

share information, transparency.

Now, all of this need a cultural change

and need the political landscape to change.

And unfortunately, right now,

we're going the opposite direction.

I mean, COVID-19 is not going to be the last one, right?

Everybody knows that.

♪ ♪

>> Go to pbs.org/frontline for a timeline

tracing the emergence of COVID-19 in China.

>> Everyone knew it was human to human transmission.

>> It's a perfect storm of multiple failures

happening at the same time.

>> And see all our coverage of the pandemic and its impact.

Connect with "Frontline" on Facebook, Instagram,

and Twitter, and stream anytime on the PBS app

or pbs.org/frontline.

♪ ♪

>> For more on this and other "Frontline" programs,

visit our website at pbs.org/frontline.

♪ ♪

"Frontline's" "China's COVID Secrets" is available

on Amazon Prime Video.

♪ ♪

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