Taiwan has accused the World Health Organization of failing to communicate an early warning about transmission of the coronavirus between humans, slowing the global response to the pandemic.
Health officials in Taipei said they alerted the WHO at the end of December about the risk of human-to-human transmission of the new virus but said its concerns were not passed on to other countries.
Taiwan is excluded from the WHO because China, which claims it as part of its territory, demands that third countries and international bodies do not treat it in any way that resembles how independent states are treated.
The WHO’s relationship with China has been criticised in the past, with some accusing the organisation of overly praising Beijing’s handling of the coronavirus outbreak despite allegations local officials had initially covered it up.
Taiwan said its doctors had heard from mainland colleagues that medical staff were getting ill — a sign of human-to-human transmission. Taipei officials said they reported this to both International Health Regulations (IHR), a WHO framework for exchange of epidemic prevention and response data between 196 countries, and Chinese health authorities on December 31.
Taiwanese government officials told the Financial Times the warning was not shared with other countries.
“While the IHR’s internal website provides a platform for all countries to share information on the epidemic and their response, none of the information shared by our country’s [Centers for Disease Control] is being put up there,” said Chen Chien-jen, Taiwan’s vice-president.
“The WHO could not obtain first-hand information to study and judge whether there was human-to-human transmission of Covid-19. This led it to announce human-to-human transmission with a delay, and an opportunity to raise the alert level both in China and the wider world was lost,” said Mr Chen, an epidemiologist by training who was health minister at the time of the Sars outbreak.
China’s health ministry only confirmed human-to-human transmission on January 20, after the WHO said in mid-January there might be “limited” human-to-human transmission but stepped back from this view on the same day.
Asked about the comments, the WHO said under its mandate it needed trust to “hold frank and open discussions on sometimes sensitive issues” and to enable this level of candour “requires that we respect the confidentiality of such communications”. Western countries have since been accused of failing to act even when they were warned about human-to-human transmission.
The WHO has had to strike a delicate balance with China throughout the outbreak, with some accusing the organisation of being too pliant while medical experts said it had coped admirably.
The challenge of managing the relationship extended to negotiations over the wording of a report following a joint mission to China last month. The nine-day trip comprised 12 WHO experts and 13 Chinese officials and was focused on the country’s response to the outbreak. Three of the WHO officials also visited Wuhan, the centre of the outbreak, as part of the mission.
The WHO’s Bruce Aylward, the Canadian epidemiologist who led the team, described the process as “fantastic”. But he told the FT there was “huge back and forth” with Chinese officials about what went into the report.
Read more about the impact of coronavirus
- The latest figures as the outbreak spreads
- How countries around the world are battling coronavirus
- How dangerous is the coronavirus and how does it spread?
Subscribers can use myFT to follow the latest ‘coronavirus’ coverage
Dr Aylward said Chinese health officials did not want to refer to the pathogen as “dangerous” as they regarded such terminology as reserved for diseases with higher mortality rates.
Chinese health officials also refused to include any reference to avoiding a “second wave” of coronavirus in the report, he said, so they compromised on “a surge” or “resurgence”.
Dale Fisher, an infectious disease specialist at the National University of Singapore, said the team’s Chinese counterparts requested the report not make reference to a “dangerous pathogen” because they said it had a “bioterrorism type suggestion”, so they found a replacement.
Clifford Lane, clinical director of America’s National Institute of Allergy and Infectious Diseases who was one of two US officials on the mission, said the WHO team’s Chinese members had “a great desire to be precise”. He said the debates over wording did not amount to censorship but represented a “bit of spin”.
China’s ministry of health did not respond to requests for comment.
Despite the criticism, the WHO has impressed many medical professionals and public health experts with its speed and effectiveness.
“The WHO has filled its leadership role admirably,” said Mark Woolhouse, professor of infectious disease epidemiology at Edinburgh University. “Though you could quibble a bit about timings, they have done all the right things so far.”
Dr Aylward added that whenever Chinese officials were reluctant to carry out a request or grant him access or were taken aback at his demands, he would always answer: “You can’t rule out another Wuhan if you don’t know how and when this started.”
He said that was always “the trigger point for them”.
“They don’t want another Wuhan,” he said.
Reporting by Primrose Riordan in Hong Kong, Katrina Manson in Washington, Kathrin Hille in Taipei and Clive Cookson in London
Copyright The Financial Times Limited . All rights reserved. Please don't copy articles from FT.com and redistribute by email or post to the web.