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A Failed Deception The Early Days of the Coronavirus Outbreak in Wuhan

In December, a mysterious new respiratory illness began spreading in Wuhan. But it took fully 21 days before the Chinese authorities mobilized to fight the disease. Could the coronavirus pandemic have been prevented?
A medical worker inside an isolation ward at a Wuhan hospital

A medical worker inside an isolation ward at a Wuhan hospital

Foto: AFP

On the morning of Dec. 20, 2019, the Chinese fish monger Chen Qingbo was cleaning out his stand at the market, completely unaware that he would soon become the focus of intense scientific research, that he was carrying a virus within him of a kind the world had never seen before. He was unaware that his fate was linked closely with that of all of humanity.

He had been up since 5 a.m. and had already made deliveries to his primary customers, including a number of hotels and restaurants in the Chinese metropolis of Wuhan. The Huanan retail and wholesale market, located not far from the train station, had been his base of operations for the last 10 years. By around 11 a.m., he had finished his work for the day and climbed into his Chevrolet for the short drive from the market to his home.

Chen is a sturdily built 42-year-old with a buzz cut and round glasses, married with two children. His small company employs three workers and he owns two delivery trucks, an apartment in Wuhan and two other apartments in his home province of Fujian. He works every day of the week, including weekends. "But on that Friday," he says, "I felt strangely tired and despondent."

Indeed, he was feeling so poorly that afternoon that he dropped by a doctor's office in his neighborhood and he received an infusion, not an uncommon treatment in China. He then went back to work on Saturday and again on Sunday and Monday, but he was feeling worse by the day, with the doctor suspecting a viral infection. Then, on Tuesday, Chen could no longer make it to the market: He had developed a fever and a cough. On Thursday, he checked into the Central Hospital of Wuhan.

Just four days later, Chen was fighting for his life. From the sample that doctors took from his lungs, a laboratory in Shanghai ultimately managed to sequence for the very first time the complete genome of an unknown virus: SARS-CoV-2, the cause of the pandemic that would ultimately spread across the entire world.

On that Dec. 20 in Wuhan, the day that Chen began feeling ill, there was nothing to indicate that a catastrophe was on the horizon. Like all cities in China, Wuhan was preparing for the Chinese New Year's festival at the end of January, an atmosphere comparable to that in Europe ahead of the Christmas holidays - days of pleasant anticipation combined with hectic preparations. Companies were planning parties while workers and students were buying train tickets back home. Communist Party officials also had plenty to do: In early January, city and provincial parliaments were scheduled to meet, an annual ritual.

Synonymous with a Pandemic

Wuhan is a vast metropolis, with a population larger than that of cities like New York, London and Paris. It is a place where important rail lines and shipping routes meet, a wealthy, modern city on the banks of the Yangtze River with an impressive skyline and an historical town center built in the European colonial style. The city's politicians and business leaders have long hoped to see Wuhan on a par with other huge Yangtze megalopolises like Shanghai, Nanjing and Chongqing.

Instead, the name Wuhan has become synonymous the world over with a pandemic. That day in December 2019, it became the birthplace of a crisis that can only be compared with the terror attacks of Sept. 11, 2001. And with the 2008 financial crisis, the consequences of which have already been overshadowed by what we are experiencing today.

The novel coronavirus has thus far killed more than 260,000 people – officially – and has plunged the global economy into an historical recession. It has changed the day-to-day lives of people around the world, fundamentally altered citizens' relationship with the state and reshaped geopolitics.

DER SPIEGEL 20/2020
Foto:

cgs

The political and economic consequences of the coronavirus are so significant that the entire world order may ultimately be transfigured. It may slow globalization, or it may accelerate it. It could catapult the world out of the industrial age into a new era. The only thing that is certain is that change is coming.

More than four months after fish monger Chen became one of the very first people to come down with the respiratory illness later named COVID-19, there are a number of theories and opinions in circulation about the origins and spread of the illness. DER SPIEGEL has reconstructed events in Wuhan in an effort to learn how the outbreak could have happened and what took place in the early days in the city's hospitals and health agencies. And to learn whether the global pandemic could have been prevented if officials, doctors and politicians had behaved differently. In short, to learn who might share the blame for this pandemic.

This reconstruction is based on numerous discussions and meetings, on reporting in Wuhan itself but also on reporting by Chinese journalists. A complete picture can only be provided by an in-depth international investigation of the kind being demanded by experts and politicians around the world - an investigation that Beijing has thus far resisted. But it can already be said with certainty that mistakes were made in Wuhan – and that the global spread of the disease could, at the very least, have been slowed.

The First Patient?

It isn't known when and where the first person became infected with SARS-CoV-2. But it is considered extremely likely that the precursor to the pathogen comes from bats – and based on genetic analysis, it is believed that the virus jumped to humans only one single time, at some point in fall 2019.

A traditional market in Wuhan: The virus only jumped to a human on one single occasion.

A traditional market in Wuhan: The virus only jumped to a human on one single occasion.

Foto: South China Morning Post / action press

That is rather unusual. It is generally the case that a longer process of genetic adaptation is necessary before a virus that originates in animals can be passed from human to human. Generally, humans repeatedly become infected by animals before a pathogen mutates such that it can be passed from person to person. But SARS-CoV-2 followed a different path. Researchers believe that a specific genetic sequence is responsible, one that joined the genome that produced SARS-CoV-2 predecessor completely by chance. It is that sequence that has made it so easy for the virus to spread.

Researchers have two hypotheses for the beginning of the pandemic: Either this genetic sequence was added to the virus when it was still reproducing in its animal host - whether it be bats, pangolins or raccoon dogs – so that the first person who became infected was immediately able to pass it along. Or a precursor was circulating unnoticed for months, but wasn't particularly contagious before the new sequence was added.

Either way, close contact between humans and animals provide ideal conditions for viruses to jump to humans. And those conditions were present at a wildlife market in Wuhan.

On Dec. 26, the day when the fish monger Chen Qingbo checked into the Central Hospital of Wuhan, the pulmonologist Zhang Jixian, 54, had her first encounter with the virus at a different clinic in Wuhan. An elderly patient was suffering from a fever, a cough and breathing difficulties and tests for influenza and other, similar illnesses had all come back negative. Dr. Zhang ordered a CT scan of the patient's lungs and found that she was suffering from a severe and unusual form of pneumonia.

Cases Begin Appearing

One day later, the neurological department asked Zhang for assistance with an elderly patient experiencing similar symptoms. His CT scan had also revealed severe pneumonia. The doctors soon figured out that the male patient and the female patient were married. "I felt something was wrong," Zhang would later tell the state-run news agency Xinhua.

The doctor learned that the son of the two patients had brought them to the hospital and she convinced him to submit to a CT scan of his own lungs. "He resisted initially," according to Zhang. "He had no symptoms and thought we wanted to get him to undergo an expensive procedure."

Once the scan was performed, though, it revealed the same lesions on the lungs that his parents had. For Zhang, it all pointed to a "contagious disease," and after a few more tests, she was convinced. "This was not an ordinary virus." That same day, she reported her findings to the authorities.

People suffering from the same symptoms were showing up at other hospitals in the city as well. Most had one thing in common: Like Chen Qingbo, they had been traders, suppliers or customers of the Huanan market.

Before it was closed down, the market consisted of two large halls separated by a broad road. Each hall contained dozens of stands and Chen's stand was in the eastern part of the market, where primarily fish and shellfish were on offer. In one corner of the larger, western half of the market, there were several stands that offered exotic wares like snake, fox and salamander meat along with scorpions, crocodiles, live hedgehogs (for the equivalent of 4.50 euros per kilogram), living wolf pups (3 euros) and civets (32 euros). Civets are thought to be the transmitter of the SARS coronavirus that began spreading in southern China in 2002.

In such markets, animals are crammed into cages in horrific conditions, and images taken from this part of the market in Wuhan before it was shuttered on Jan. 1 show dismal-looking stands with dire hygienic conditions. Even today, more than four months later, you can still smell the rotten stench if you approach the site, which has been completely cordoned off.

"They allegedly also sold pangolins there," says Chen Qingbo. "But I never saw them. I never went over to those stands. I find wild animals to be dirty and I'm afraid of them." The eastern part of the market, by contrast, was a completely normal Chinese market, says Qingbo. "Even the restrooms were OK. They were cleaned every day."

Critical Condition

After he was taken to the Central Hospital, Chen's condition worsened quickly. He was hardly able to stand on his own and his temperature climbed to 39.8 degrees Celsius (103.6 degrees Fahrenheit). He grew panicky when the doctor showed him the CT scan of his lungs. "He told me he had never seen such bad pneumonia. Three quarters of my lungs were completely white in the scan." On Dec. 30, Chen lost consciousness. The doctors took a sample of the fluid in his lungs and told his family that he was in critical condition.

At this point, they had just an initial idea of what kind of virus they could be facing. Several days earlier, the Wuhan Central Hospital had sent a sample from a patient suffering from similar symptoms to Vision Medicals, a genetic laboratory in Guangzhou, and on Dec. 27, the lab had got back to them with the results. "They just called and told us that it was a new type of coronavirus," a head physician from the hospital told the magazine Caixin, adding that he was surprised they hadn't sent a written report.

Because most of those infected with SARS-CoV-2 experience mild symptoms or none at all, scientists now believe that the virus had already spread widely by this point - in Wuhan and likely beyond. Several months later, French doctors went back and tested old samples from patients who had reported flu-like symptoms and found that a man near Paris had become infected with the novel coronavirus as early as Dec. 27.

"I think that the more people look, the more such early cases will be found," says Thomas Briese, a professor of epidemiology at Columbia University Medical Center in New York. A group of British and French scientists did something similar, combing through an online database on the search for tiny differences in genome sequences in thousands of SARS-CoV-2 samples from around the world. In the journal Infection, Genetics and Evolution, they write: "The genomic diversity of the global SARS-CoV-2 population being recapitulated in multiple countries points to extensive worldwide transmission of COVID-19, likely from extremely early on in the pandemic."

Identifying the Virus

"It seems unlikely to me that a global spread could have been prevented," says Gérard Krause, head of epidemiology at Germany's Helmholtz Center for Infection Research. Nevertheless, says Torsten Feldt, infectiologist and chief physician at the University Hospital of Düsseldorf, "I am quite certain that many lives would have been saved by an earlier lockdown."

On the afternoon of Dec. 30, Ai Fen, head of emergency services at the Wuhan Central Hospital, received the test results of yet another patient. The test had been performed by a laboratory in Beijing called CapitalBio and the doctor found the results deeply unsettling. The finding: "SARS-coronavirus."

SARS first appeared out of the blue in the early 2000s, an unknown infectious disease with the potential to trigger a pandemic. That illness killed just 774 people before it was then stopped, essentially a warning shot to the world. Was it now back?

"I was so scared I broke out in a cold sweat," Ai later described her reaction on reading the lab report. She informed the clinic leadership, marking the words "SARS-coronavirus" on the report with a red pen, took a photo and sent it along with a patient's CT scan to former medical school classmates and to colleagues in her ward – "to remind everybody to be careful."

Ai's message also reached her colleague Li Wenliang, who worked as an ophthalmologist on the third floor of the Central Hospital. At 5:43 p.m., he used WeChat to inform university friends of a presumed SARS outbreak. An hour later, he amended his message due to the apparent preliminary nature of the results from the Beijing laboratory: "It has been confirmed that it is a coronavirus infection, but the precise subtype of the virus is still being evaluated."

As it would turn out, the new pathogen is similar to the SARS coronavirus -- it's not quite as deadly, but it's apparently even more contagious. And the doctors Ai and Li were right to issue warnings, as events would soon show.

On the morning of Dec. 31, officials in white protective suits began disinfecting the Huanan market. Meanwhile, the health agency issued its first public statement on the new illness: In Wuhan, it said, 27 cases of "pneumonia of unknown causes" had appeared. Thus far, the statement continued, there were no confirmed cases of human-to-human transmission.

That last piece of information was reassuring to doctors, researchers and health policy officials around the world. And it seemed perfectly plausible: New viruses generally tend to spread slowly early on.

Twenty-One Wasted Days

But despite its plausibility, the information was incorrect. SARS-CoV-2 was an exception. It could be that there were no confirmed cases of human-to-human transmission in late December, but the findings by doctors leave no doubt that such transmissions had long since begun.

Fully 21 days would pass, however, before the Chinese government publicly admitted as much – three weeks that contributed immensely to a local epidemic rapidly growing into a worldwide pandemic.

Dr. Ai Fen: "I was so scared, I broke out in a cold sweat."

Dr. Ai Fen: "I was so scared, I broke out in a cold sweat."

Shi Zhengli is the most accomplished scientist at the Wuhan Institute of Virology. She was at a conference in Shanghai when she received an urgent phone call from Wuhan telling her to drop everything she was doing. Samples had arrived, she was told, from seven patients exhibiting SARS-like symptoms.

Shi is an internationally recognized virologist who has been nicknamed "Bat Woman" by her colleagues for the virus research she has performed on the animals. She was the one who first identified the viruses that SARS derived from and she has published numerous papers in well-respected journals. In the PubMed database, she is listed with 66 papers published about coronaviruses.

Her team spent the next several days feverishly sequencing the genetic code of the new virus, but Shi herself concentrated on trying to find out whether the new virus matched one of the viral strains on which her institute had been conducting research in recent years. She was initially concerned that an accident may have occurred and a sample may have escaped her laboratory.

The Wuhan Institute of Virology, where she works, is a sprawling complex surrounded by a high electric fence in the southern part of the city. Five years ago, it became the first research site in China with the highest biosafety level BSL-4.

Problems with Reporting

But it wasn't the only state laboratory where Chinese researchers were working hard to sequence the virus. Lan Ke, director of the State Key Laboratory of Virology at Wuhan University, received samples on Jan. 2 containing lung secretions from two patients from Zhongnan Hospital for analysis. "Honestly, my first though was that it could be a new pathogen to be identified," he told DER SPIEGEL. "But we were not sure if it was SARS." By Jan. 3, he and his team had detected the first RNA fragment of the pathogen. They then decoded the sequence and compared it with known viruses using an online database. They found no matches. The scientists furthermore recognized that the pathogen was less similar to SARS than it was to bat-born coronaviruses.

On Jan. 11, the Shanghai Public Health Clinical Center became the first to publish the genome sequence of the pathogen, doing so on the research website virological.org. The sequence came from a sample taken from the fish monger Chen Qingbo.

The next day, the center was temporarily closed down by Chinese authorities. No reason was given for the move.

On Dec. 31, Chen Qingbo was transferred from the Central Hospital of Wuhan to the Jinyintan Hospital, the first of the city's large hospitals to be dedicated specifically to treating patients suffering from the novel coronavirus. The fish seller initially ended up in the intensive care ward, but he was unaware of what was happening to him. He also still didn't know - though it is likely – whether he was among the 41 patients chosen by specialists in the hospital to be part of a study that would be published three weeks later in the respected medical journal The Lancet. Even today, it remains one of the most important clinical studies on the early phase of the crisis.

Once his condition began improving and he was transferred to a different ward, Chen started receiving visits from "people from health services or some provincial agency." He says they would show him their IDs and ask him questions. "I don't know anymore who they were or what they wanted," he says. "I could only see their eyes behind thick protective goggles."

Chen has precise memories, though, of the mayor of Wuhan visiting his ward on Jan. 6. "After he left, the nurses told us that the government would be paying for our treatment from then on. And shortly thereafter, all of our costs were reimbursed."

On Jan. 3, Wuhan health officials reported 44 patients with unidentified viral lung infections, including 11 serious cases such as the one experienced by Chen Qingbo. But the number did not reflect the true expanse of the crisis. Many increasingly frustrated doctors were having difficulties reporting the number of new infections to the authorities.

Patients waiting to be transfered to another hospital in Wuhan: The city also provided the blueprint for combating the pandemic.

Patients waiting to be transfered to another hospital in Wuhan: The city also provided the blueprint for combating the pandemic.

Foto:

STR / AFP

That system for reporting infections is the key element in what are actually strict regulations in China designed to track outbreaks of contagious diseases. The system was introduced following the SARS crisis and requires clinics to report suspicious cases to the government in Beijing without delay. The system is "quite simple," a doctor told the magazine Caixin. "Prior to corona, when we discovered a case of hepatitis B or another serious infectious disease, we were able to enter our diagnoses directly. A report card would open up, which we would fill out and then click "OK" to upload it."

State Interference

It was this system that provided Beijing with a timely warning in 2013 of the bird flu outbreak and, in November 2019, of two pneumonic plague cases in Inner Mongolia. But in Wuhan, it suddenly stopped working. The authorities began demanding that hospitals first clarify each new case with the local authorities before they were allowed to upload them into the national reporting system.

In early January, scientists at several genetic laboratories received calls from provincial health authorities from the province of Hubei. They were asked to stop work on the analyses they were currently performing and to destroy their samples. They were then told: "If you perform tests in the future, be sure to report to us," one of the scientists later told Caixin.

As early as Dec. 29, the Central Hospital of Wuhan had sent four reports of corona cases to the local health office for appraisal. The head of the office promised to report back soon, adding that similar case reports had been received from other clinics. Two days later, the doctors asked about the results, but were told to be patient. On Jan. 3, they asked if they should post the case reports - seven of them by then – to the national reporting system. They were asked to wait.

The most important political events of the year, after all, were imminent. On Jan. 6, a session of the city parliament was set to begin, and the People’s Congress for the Hubei province was to convene on Jan. 11. And it was now that the provincial government also issued an order that entries into the national disease tracking system be made "cautiously.” Entries were to be coordinated not just with the local health authorities, but also with the city and provincial governments.

The authorities were doing all they could to keep both the public and the central government in the dark about the true extent of the epidemic – likely to prevent the disruption of the two parliamentary sessions. It could, however, also have been because they simply didn't want to spread bad news – especially not to Beijing.

The loudest voices, the doctors Ai Fen and Li Wenliang, had already been silenced by then. On Jan. 2, Ai was given an "unprecedented, extremely harsh reprimand,” as she would later say in a magazine interview. Then, on Jan. 3, the police interrogated Li and he was forced to pledge in writing that he would cease spreading "rumors.” He returned to the hospital and contracted the virus himself on Jan. 8.

But even as the authorities sought to downplay the crisis, an increasing number of people infected with the virus began turning up at Wuhan hospitals. The city’s health authority reported only 59 cases on Jan. 5, and on Jan. 11, it even spoke of "41 initially diagnosed cases.” It claimed that there had been "no new cases” since Jan. 3. Against all evidence, the authority also stated that there was no indication that the pathogen, which was now being referred to as the "novel coronavirus,” was transmissible from human to human.

Evasive Answers

But the bad news reached Beijing, anyway, despite the lies from the local authorities. Virologist Gao Fu, the head of China’s Center for Disease Control and Prevention, has made a habit of scanning China's internet before bedtime for indications of possible disease outbreaks. On Dec. 30, Gao came across rumors about an internal memo from the Wuhan Health Commission on the outbreak of an undefined lung disease. He called an official at the authority and was exasperated by the evasive answers he was given.

The next morning, Gao sent the first of three teams of experts to Wuhan. The Beijing office of the World Health Organization was also officially informed that same day. Shortly afterward, Gao spoke by phone with Robert Redfield, the director of the Centers for Disease Control in the United States, who was on vacation at the time. Redfield was deeply disturbed about what Gao had to report. According to a report in the New York Times, Gao even broke into tears during a later conversation with Redfield.

Meanwhile, officials in Wuhan continued to play down the situation to their colleagues in Beijing. "They said the course of the disease was mild, not much different from seasonal flu,” says a member of the second Beijing delegation, which would arrive in Wuhan about a week later.

The local authorities even issued an order that the only patients that should be counted were those who had themselves been to the Huanan market or had a connection with a visitor to the market. As a result of that order, the growing number of infections simply vanished from the statistics. An increasing number of infections, after all, had no connection with the market whatsoever.

Still, even though Beijing was now aware of the situation, official reporting did not change.

The city of Wuhan on Feb. 3: The largest quarantine ever imposed in the history of humankind.

The city of Wuhan on Feb. 3: The largest quarantine ever imposed in the history of humankind.

Foto: Wang He / Getty Images

And the Wuhan health authority continued to lie: On Jan. 11, it reported that there hadn't been a single known case among medical staff. In chatrooms, though, the opposite claim was spreading, something that epidemiologist Li Lanjuan learned on Jan. 17. Alarmed, she reported to the National Health Commission and requested permission to drive to Wuhan immediately. Officials in Beijing agreed. On Jan. 18, Li left for the city together with five other epidemiologists. It was only after this visit by the third Beijing delegation that the world would find out what was happening in Wuhan.

The team visited several hospitals, the Huanan market and the Center for Disease Control located only 300 meters away. The experts no longer had any doubts about human-to-human transmission of the virus or that medical personnel had themselves become infected. In a confidential meeting, Li urged that the highest disease alert level - normally reserved for plague or cholera outbreaks – be declared. She proposed sealing off the city of Wuhan. There were only a few days left until the peak of the New Year travel season, and the concern was that the disease could spread throughout the country.

Sealing Off Wuhan

The experts flew back to Beijing on Jan. 19 armed with these recommendations. At around midnight, they were received by the Chinese health minister, and the next morning, they attended a cabinet meeting in Zhongnanhai, the innermost circle of power in the Chinese leadership. They issued their warnings at the meeting.

It was then, on Monday, Jan. 20, that the Chinese and the rest of the world would learn of the shocking news from Chinese media. Three days later, in the early morning hours of Jan. 23, Beijing moved to seal Wuhan off from the outside world. In the following days, the lockdown would be extended to include the entire Hubei province. Around 60 million people were ordered to shelter in place in their homes in the largest quarantine ever imposed in the history of humankind.

On the morning of Jan. 23, Wuhan was smothered in a thick layer of smog, with particulate matter levels at six times the legal limit. But there were very few cars on the streets and the few people who did attempt to leave the city were turned back. A convoy of police buses arrived at the airport and by 10 a.m., it was no longer possible to leave the city by air either.

There were also long lines of people in front of hospitals, while emergency rooms had become places of panic and desperation. Ai Fen reported that more than 1,500 patients were now crowding into her department each day, "three times the usual maximum.” More than 200 of the 4,000 employees at the Wuhan Central Hospital got infected with the virus at the peak of the epidemic.

Ophthalmologist Li Wenliang was so ill by the end of January that he had to be transferred to the intensive care unit and intubated. On Jan. 27, he defied the official ban on speaking to the press and gave an interview to the state-run Beijing Youth Daily using a messaging app.  He could no longer speak. On Feb. 5 and 6, his condition deteriorated further and he had to be placed on life support. The hospital reported on his treatment using the microblogging platform Weibo. Some 17 million users followed the increasingly hopeless developments late into the night.

Shortly before 3 a.m., the doctors lost the battle to save their colleague’s life. It unleashed an overwhelming wave of sympathy, with 870,000 users expressing their anger and grief on the internet, leading the state to ultimately abandon its censorship efforts. Li, 33, who left behind a son and a pregnant wife, embodied the center of Chinese society, precisely that segment on which the party bases its rule: the young, hard-working and well-educated. Like many doctors, he had been a member of the Communist Party.

The death of Li Wenliang, who had seen the danger coming, had warned his friends and colleagues and was punished for his efforts, shook many young Chinese so deeply that for a few days it appeared as though the party might lose its hold on society. In some ways, it was evocative of 31 years before, when the death of Hu Yaobang, a politician also revered by many young Chinese and humiliated by the party, triggered the protests in Tiananmen Square.

This time, though, there were no protests. Mourners laid flowers and candles in front of the Central Hospital. The party hastened to announce that it had expressed its condolences to Li’s family and it initiated an investigation on the day of his death into the events surrounding his interrogation. A few days later, the government declared Li and 13 other doctors who had died of COVID-19 as "martyrs.”

Mobilizing All Resources

By now, the state and the party were now moving to mobilize all available resources. In the northwest and far south of the city of Wuhan, the People’s Liberation Army set about constructing two emergency hospitals with more than 2,500 beds, finishing the job within two weeks. Stadiums and convention centers were also converted into makeshift hospitals, and within days, block after block of apartment buildings had been cordoned off, with party members standing guard to make sure people didn’t leave their homes.

Virologist Gao Fu: Exasperated by the evasive answers he was given.

Virologist Gao Fu: Exasperated by the evasive answers he was given.

Foto: Mark Schiefelbein/ AP

The world watched in a daze as China’s leaders submitted millions of people to its quarantine regime. DER SPIEGEL and other Western media wrote that a lockdown that strict was "unthinkable in a democratic society.” At that point, few had any idea that the events in Wuhan were providing a glimpse into their own future - and that only a few weeks later, a significant segment of the global population would find itself stuck in a similar situation. Far from just being the breeding ground for the virus, Wuhan also provided a blueprint for fighting the epidemic.

Eleven weeks after the lockdown was imposed on Wuhan, Wang Xinghuan, the director of one of the largest hospitals in the city, was standing outside his clinic in a tracksuit and speaking of the lessons he had learned from the crisis. "Three things are essential," he said, "rigorous testing, the immediate isolation of suspected cases and the wearing of masks." He said that he was in regular contact with colleagues in New York and that one of them had told him that the wearing of masks was unfortunately a cultural issue. "But it isn't a cultural issue," Wang insisted. "It's stupid to not wear a mask."

In March, an international team of epidemiologists calculated that the number of infections would have been three-times, seven-times or 18-times higher respectively if China had imposed the lockdown on Wuhan one, two or three weeks later than it did. It is difficult to imagine how many cases and deaths there might be in the world today had the country waited.

But the same study estimates that the numbers would have been 66 percent, 86 percent or 95 percent lower respectively had the government closed off the city one, two or three weeks earlier than it did.

Depending on one's perspective, then, Beijing is to be commended for protecting the world from a much greater catastrophe - or is to be condemned for triggering the disaster we are currently experiencing in the first place.

In February, the regime began pushing the first of the two narratives. Chinese President Xi Jinping has even claimed that he personally issued "specifications for the prevention and control of the novel coronavirus" way back on Jan. 7 in a speech before the Politburo Standing Committee. The text of that speech has not been released to the public, but anonymous sources have said that Xi merely decreed that the measures should not detract from the "festive atmosphere" ahead of the Chinese New Year.

The Chinese PR Campaign

The question regarding when Xi learned of the new virus is crucial when it comes to assigning responsibility. There are a number of indications that Beijing was misled by the provincial government and that the central government only recognized the severity of the epidemic in mid-January. But if Xi really was aware of the problem on Jan. 7, then he would have to bear responsibility for the fact that the world was deceived for so long regarding the true nature of the disease.

Wuhan's new top Communist Party official - his predecessor was fired in February – proposed in early March that the people of the city undergo "gratitude education." The party went on to publish a book called "2020: A Battle Against the Epidemic," which honors Xi's alleged accomplishments in the "people's war" against the virus. Following a wave of indignation in the Chinese internet, though, the campaign was soon suspended.

The government, however, can now point to foreign sources to prop up its version of events. WHO head Tedros Adhanom Ghebreyesus said he had been "impressed and encouraged by the president's detailed knowledge of the outbreak" following a visit he made to Beijing in late January. Quotes such as this one are quite helpful to Beijing, both for its domestic propaganda and for its international PR campaign, which seems to be growing in strength by the week.

In this battle over the coronavirus narrative, Chinese diplomats eagerly cite statements and tweets from U.S. President Donald Trump. Quotes like this tweet from Jan. 24: "China has been working very hard to contain the Coronavirus. (…) I want to thank President Xi!" Or this remark from Feb. 7: "I just spoke to President Xi last night. (…) I think he's handled it really well."

In the meantime, of course, Trump has begun disputing the numbers that he was praising just 10 weeks ago and is now accusing China of lying – and he's not the only one. He has also begun claiming that he has intelligence information whereby the virus actually escaped from a Chinese laboratory, a reference to the Wuhan Institute of Virology in the southern part of the city – the lab where "Bat Woman" Shi Zhengli works.

People pay respect at a memorial to Dr. Li Wenliang: "There should be more than one voice in a healthy society."

People pay respect at a memorial to Dr. Li Wenliang: "There should be more than one voice in a healthy society."

Foto:

Lam Yik Fei / The New York Times/ Reudx/ Laif

In February, Shi told the U.S. magazine Scientific American that she worked day and night at the beginning of the epidemic comparing all the samples the institute had ever used for research with the genome sequence of SARS-CoV-2 - and found no matches. "That really took a load off my mind," she told the magazine. She believes her lab bears no responsibility for the outbreak.

In mid-April, only a few cars could be seen on the other side of the electric fence in the parking lot of the Wuhan Institute of Virology. Visitors are not welcome. A car drove up and a young man in street clothes introduced himself as Mr. Zhao from "Bio Security." He demanded to know what the reporter was looking for. An interview with Dr. Shi, perhaps? "Impossible," was the response. But wouldn't it be helpful to respond to the rumors that are spreading around the world? Mr. Zhao smiled. "It doesn't matter what we say. These theories will spread regardless."

Defeating the Conspiracy Theories

Some of those theories are rather preposterous. Nobel prize laureate Luc Montagnier, who was one of the scientists to discover the virus that causes AIDS, claimed on French television that SARS-CoV-2 was produced in the lab and contains genome sequences from the HIV virus. Researchers were quick to contradict him: "Montagnier failed to find that both fragments are actually also commonly found in many other viruses, including coronaviruses from bats and pigeons," the team of Yang Zhang, professor of computational medicine and bioinformatics at the University of Michigan, told DER SPIEGEL.

The most likely scenario is that the two genome fragments ended up in SARS-CoV-2 as the result of a completely natural process. That, at least, is what the vast majority of leading virologists believe.

It is, of course, possible that an employee of the Wuhan Institute of Virology may have become infected with an unknown, natural bat virus despite wearing protective clothing, but it is "extraordinarily unlikely," says Robert Garry of the Tulane University School of Medicine.

U.S. intelligence likewise issued a statement saying that the broad consensus is that the virus is not manmade. China has thus far refused to permit an international investigation into the origins of the virus. But without such a study, rumors will continue to spread regarding the beginning and development of the disease.

A particularly absurd conspiracy, which ironically originated in the U.S., has been spreading in Wuhan itself. The fish seller Chen Qingbo says that "many of my friends believe, as do I, that the virus was brought to Wuhan during the Military World Games last fall. The U.S. athletes apparently stayed in a hotel not far from the Huanan market and some of them allegedly were suffering from a similar illness." He then asks: "Couldn't that be true?"

Following his recovery, Chen was released from the hospital on Jan. 11, well before the epidemic reached its peak. After finishing his quarantine, he received a text message from the hospital's chief physician: "Recovered patients are kindly requested to donate blood plasma for scientific purposes." Chen responded immediately and has been to the hospital five times since then. He has resumed working, but he now supplies fruit and vegetables instead of fish. And he now works out of a different market.

Ai Fen is still the head of emergency services at the Central Hospital of Wuhan. On March 10, she gave a long interview to China's state-run People magazine in which she said: "I regret that back then I didn't keep screaming out at the top of my voice. I've often thought to myself what would have happened if I could wind back time."

The comments were online for three hours before they were deleted by the censors. But not before users had saved them and translated them into English, German, Italian and even brail. It continues to be shared widely today.

The interview with Beijing Youth Daily that ophthalmologist Li Wenliang tapped out on his mobile phone 10 days before his death was removed by censors. But a few days after he gave that interview, the magazine Caixin reached him as well, and that text can still be accessed. "I think," he says in the piece, "there should be more than one voice in a healthy society."

With reporting by Wu Dandan