April 14, 2020: President Trump, speaking at The White House—“Today, I am instructing my administration to halt funding of the World Health Organization while a review is conducted to assess the World Health Organization's role in severely mismanaging and covering up the spread of the coronavirus…The WHO's reliance on China's disclosures likely caused a 20-fold increase in cases worldwide, and it may be much more than that. The WHO has not addressed a single one of these concerns nor provided a serious explanation that acknowledges its own mistakes, of which there were many…so much death has been caused by their mistakes.” Here are the facts.
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Chinese officials first reported the existence of atypical cases of pneumonia in Wuhan, China, to WHO's China Country Office in Beijing on Dec 31, 2019. An Incident Management Support Team was established the next day. On Jan 4, 2020, WHO tweeted that “#China has reported to WHO a cluster of #pneumonia cases—with no deaths—in Wuhan, Hubei Province. Investigations are underway to identify the cause of this illness.” On Jan 5, the agency described a “pneumonia of unknown cause” in its official disease outbreak news. By Jan 7, Chinese scientists had identified the causative agent as a novel type of coronavirus. China shared the genetic sequence on Jan 12. Details of the illness were now being reported by Chinese officials to WHO. Among the first 41 cases, the earliest symptoms began on Dec 8. Also on Jan 12, WHO reported there was “no clear evidence of human to human transmission”. They noted that Chinese authorities claimed “No additional cases have been detected since 3 January 2020”. On Jan 13, WHO reported that Dr Tedros would be consulting with members of the International Health Regulations (IHR) Emergency Committee, the group that advises the WHO Director-General on whether there is sufficient evidence to declare a Public Health Emergency of International Concern (PHEIC). On Jan 14, the possibility of human-to-human transmission was raised by WHO's Maria Van Kerkhove at a WHO press briefing (human-to-human transmission was eventually confirmed by Jasper Fuk-Woo Chan and colleagues, in a paper published in The Lancet on Jan 24). Meanwhile, Chinese experts from Beijing visited Wuhan to investigate the outbreak and were followed, on Jan 20–21, by a team from WHO. The IHR Emergency Committee met on Jan 22–23. After a split vote, they reconvened on Jan 30 and concluded that the outbreak fulfilled criteria for a PHEIC, which Dr Tedros duly declared the same day. What can one conclude from this timeline? It took WHO just 4 days to inform the world about the existence of this new atypical pneumonia. It took WHO just 30 days to declare a PHEIC. President Trump's charge is therefore without foundation. On Feb 24, President Trump tweeted that “CDC & World Health [Organization] have been working hard and very smart”. His present attack on WHO contradicts his earlier praise for the agency. On the issue of human-to-human transmission, WHO reported the facts as they had them. They knew and said publicly by Jan 14 that human-to-human transmission was possible given this was a coronavirus of a similar type to that which caused severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Still, there are legitimate questions. First, there is a gap in the timeline between Dec 8 and Dec 31. What did Chinese authorities in Hubei province and Beijing do during this period? Second, why did Chinese authorities tell WHO on Jan 11–12 that no additional cases of coronavirus disease 2019 (COVID-19) had been detected since Jan 3? And third, last week saw Chinese officials revise their Wuhan mortality estimates for COVID-19 upwards by 50%. But that only takes China's total number of COVID-19 deaths to 4642, according to WHO. Can that figure be believed? By making unfounded allegations against WHO and by stopping much-needed financial aid to the agency during a global health crisis, President Trump has damaged the integrity of his office and his government. Global health, and global health security, needs a strong WHO and it needs a strong US Government to support WHO. President Trump's decision to harm an agency whose sole purpose is to protect the health and wellbeing of the world's peoples is a crime against humanity. It is a knowing and inhumane attack against the global civilian population. He should restore WHO's funding immediately and offer the agency his full and unconditional backing.
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