Coronavirus Outbreak: WHO’s policy failures and capitulation to China fueled deadly pandemic; DG Tedros must be held accountable
There’s enough evidence now to conclusively argue that instead of anticipating and preempting the worst pandemic in a century, World Health Organization’s capitulation to China and series of bewildering policy failures have misled and delayed international response, thereby exacerbating fatally the pathogen’s impact.
As global coronavirus cases cross one million and deaths near 60,000, at what point do we point a finger at the institution that was set up precisely to forestall such pandemics and limit their impact?
There’s enough evidence now to conclusively argue that instead of anticipating and preempting the worst pandemic in a century, World Health Organization’s capitulation to China and series of bewildering policy failures have misled and delayed international response, thereby exacerbating fatally the pathogen’s impact. The WHO and its director general Tedros Adhanom Ghebreyesus are accountable and answerable for this failure.
In this piece, I shall focus on three areas where WHO’s failures have been stark. WHO, set up under the aegis of United Nations, draws its legitimacy from the notion that it is an apolitical institution run by domain experts from medical and scientific communities.
Its stated purpose is to keep the world safe, promote health and coordinate with signatory nations. On each of these parameters, coronavirus has revealed WHO to be an incompetent organisation under a leader whose pronounced deference to China’s interests was there for the world to see.
WHO’s bewildering messaging on masks
Nothing exposed WHO’s ineptitude more than its messaging on masks. Its advice for public on this crucial equipment was confusing. It ended up eroding people’s trust in the institution, not to speak of misleading a bunch of nations in their battle against the coronavirus .
Right from the onset of the pandemic, WHO advised (and continues to advise) people against wearing a mask despite overwhelming scientific evidence that masks play an invaluable part in preventing virus transmission in public along with hand-washing and social distancing.
On the question “Should I wear a mask to protect myself”, the WHO website states: “If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection,” and goes on to add: “Wear a mask if you are coughing or sneezing.”
In other words, the WHO claims that ordinary people do not need masks to protect themselves against the virus. The message is most likely an attempt to manage the scarcity of crucial personal protective equipment (PPE) for health workers around the world amid reports that PPE supply is critically short of demand. If that was the purpose, WHO should have been honest about the real reason instead of promoting a flawed policy that likely affected thousands worldwide.
There is overwhelming evidence that countries that have a culture of wearing masks or an experience in combating the SARS outbreak in 2003, did much better in flattening the curve. Hong Kong’s top infectious disease expert, 63-year-old microbiologist Yuen Kwok-yung, played a key role in arresting the SARS outbreak that gravely impacted the nation in 2003.
In an interview to The Straits Times, professor Yuen criticised WHO’s policy recommendation that healthy people need not wear masks. “If people wear masks only when they feel sick, then the eight infected people on the Diamond Princess would have transmitted it to others because they were not feeling uncomfortable. Wear a mask to protect not only yourself but also others, because if you are infected but asymptomatic, you could still stop the spread by wearing a mask. In our experiments previously, we found 100 million virus strands in just one milliliter of a patient’s saliva.”
WHO’s recommendation not only stigmatizes those that are sick, it also overlooks the fact that normal human speech involves spraying of saliva that allows the pathogen to spread.
Professor Yuen’s views have been seconded by China’s top scientist George Gao who told Science magazine that US and Europe are committing a “big mistake” in not asking people to wear masks. “This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth.”
Moreover, there is now mounting evidence that as many as 25 percent of people infected with coronavirus may not show any symptoms at all, but these asymptomatic patients may still infect others.
This “high level of symptom-free cases is leading America’s Centers for Disease Control and Prevention to revise its earlier guidelines on masks and advice general public to wear them.
Surgeon general says the CDC now recommends wearing face masks in public because recent studies show "a significant portion of individuals" with coronavirus don't show symptoms, and can unknowingly transmit the virus to others https://t.co/b9FtmY5sM4 pic.twitter.com/auhcgeFsQT
— CBS News (@CBSNews) April 3, 2020
And yet we have WHO telling the world on 31 March that “there is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit.” WHO’s advice looked all the more stupid especially when its own officials showed up in news conferences wearing masks.
Happening now in Beijing: Dr Bruce Aylward explains the impact of outbreak containment measures at a press briefing on the @WHO-China Joint Mission on #COVID19 pic.twitter.com/DpCpEdZOlT — World Health Organization Western Pacific (@WHOWPRO) February 24, 2020
The concern that widespread mask usage may deprive heath workers and first responders of N95 or other high-tech masks is legitimate. What WHO should have done is advise people to wear basic or low-tech masks (that may be made even at home) because there’s evidence to suggest that even a mask made out of a T-shirt at home may arrest the spreading of virus.
Data-focused research institute fast.ai cited 34 scientific papers that indicate even low-tech basic masks can be effective in reducing virus transmissions in public.
Advice against travel ban
WHO’s travel advice has been a scandal. Even when it had clear evidence of a raging pandemic originating in China, DG Tedros steadfastly resisted a travel ban and blundered on declaring that the pathogen is capable of human-human transmission despite early warnings.
WHO would continue to deny human-human contamination of the coronavirus and kept on placing utmost faith on data emerging from China, which has proven to be an unreliable source.
On 5 January, it released a statement declaring that according to “preliminary information from the Chinese investigation team, no evidence of significant human-to-human transmission and no health care worker infections have been reported.”
This advice was repeated on 14 January, relying again on Chinese diagnosis.
Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China🇨🇳. pic.twitter.com/Fnl5P877VG
— World Health Organization (WHO) (@WHO) January 14, 2020
WHO finally revised the declaration on 23 January, but not until 11 March would we know that it is a pandemic. WHO’s procrastination and blind faith in questionable Chinese data (Washington Post claims China’s actual toll could be over 40,000) had real consequences and likely prevented nations from taking preemptive and tough decisions.
Europe, which has been ravaged by the virus, dithered on restricting direct flights to and from Wuhan based on WHO’s assessment. “Considering there is no indication of human-to-human transmission and no cases detected outside of China, the likelihood of introduction to the EU is considered to be low, but cannot be excluded,” noted European Centre for Disease Prevention and Control in a 10 January advisory.
“These decisions have had global consequences, as WHO guidelines are for better or for worse followed by countries and even by private actors who can base — and later justify — their actions from these guidelines. Such was the case for example in France, where public authorities were still saying there was no proof of human to human contamination on 20 January,” writes François Godement in his article for French think tank Institut Montaigne.
When WHO should have been banning travel to and from China when there was clear evidence of a respiratory contagion capable of human-to-human transmission, it did the opposite.
During a briefing to UN’s executive board in Geneva, DG Tedros said: “We reiterate our call to all countries not to impose restrictions that unnecessarily interfere with international travel and trade. Such restrictions can have the effect of increasing fear and stigma, with little public health benefit.”
The DG’s focus on “travel and trade” amid pandemic to save China from “stigma” now appears a costly oversight and a glaring policy failure. While Tedros was proclaiming that “widespread travel ban is not needed to beat China virus”, China was busy capitalising on WHO’s advice to denounce countries that had by then imposed travel bans and canceled visas.
While Beijing fulminated against travel bans when the virus was raging in Wuhan, it did just the opposite when it had managed to flatten the curve — blocking all foreigners from entering China.
The action of Tedros contrasts sharply with WHO’s action during the SARS outbreak in 2003 when led by then DG Gro Harlem Brundtland, the institution had slammed China for suppressing data and “lack of cooperation with the international community.”
In an unprecedented step, WHO also issued a travel advisory in 2003 to limit the spread of SARS, postponing all but essential travel.
While China’s pattern of operation did not change from one outbreak to another, WHO, led by its new DG, failed to act as the gatekeeper.
WHO’s deference to China
Tedros’s deference to China is tragic, but not inexplicable. Instead of acting as the head of an apolitical institution, Tedros has been busy pandering and defending Beijing in spite of its mismanagement, data suppression and lies.
For China, the defeat of the virus was a geopolitical necessity to show the world that its authoritarian system is a better model of governance, and it did everything from destroying proof, fudging data to bullying whistleblowers to demonstrate that it managed the pandemic better than liberal democracies. WHO acted as the facilitator of this dubious geopolitical game.
At every crucial inflection point during the outbreak, WHO managed to let the world down. It was tragically amusing to see China itself admitting its mistakes in not disclosing information “in timely manner” in a rare instance of introspection and Tedros going out of his way to absolve Beijing of all culpability — repeatedly praising China’s actions.
Tedros even claimed that “if it weren’t for China’s efforts, the number of cases outside China would have been very much higher.”
On the Taiwan question, WHO’s capitulation has been total. A senior WHO official cut short an interview when confronted with the question why Taiwan has not been granted membership.
When the journalist from Hong Kong repeated the question after reconnecting, Bruce Aylward, senior advisor to Tedros, abruptly ended the call.
Taiwan’s non-inclusion is a result of Chinese pressure on WHO. Beijing doesn’t want the institution to confer on Taiwan the status that other nations enjoy, to delegitimise the Taiwanese government.
Tedros’s link with China has been a topic of much discussion. There have been credible reports that China worked hard behind the scene in 2017 to install the former Ethiopian health minister as the DG. As Sunday Times noted in October 2017, “Chinese diplomats had campaigned hard for the Ethiopian, using Beijing’s financial clout and opaque aid budget to build support for him among developing countries. China has praised the authoritarian development model of Ethiopia’s regime, which rules under emergency powers and has put down pro-democracy protests.”
Tedors’s loyalty to China, however, has critically undermined the global fight against the pandemic. As the leader of WHO, Tedros’s actions have critically eroded trust in the institution and lowered its credibility. It further illustrates the danger that China poses to global institutions.
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