On Jan. 15, the regional health commission in northern China’s Inner Mongolia issued a “super urgent” emergency notice to its municipal counterparts, explaining how medical facilities should respond to a new form of pneumonia.
… First, it asked hospitals to take measures to prevent the disease from spreading inside their facilities and train staff on such actions.
Second, it asked hospitals to set up fever clinics, and to “pre-screen and triage” any patients with fever.
Hospitals should also ask those patients if they had been to markets in Wuhan in the previous two weeks…
Finally, the notice asked hospitals to set up special treatment teams. Infectious disease experts must be included among the team members, it said.
The Inner Mongolia health commission … stated that the notice was “for internal use only, and cannot be distributed on the internet.”
In another internal document issued on Jan. 15 by the local health commission in Xilingol League, one of 12 administrative leagues within Inner Mongolia, authorities also emphasized fever as a key symptom.
On Jan. 19, a top Wuhan health official took questions from reporters, saying that he could not “rule out” human-to-human transmission, “but its risk was rather low.”
On Jan. 23, three days after Zhong’s public statement, China’s National Health Commission publicly releasedthe third edition of a document titled “Diagnosis and Treatment Plan for the New Coronavirus.”… that pneumonia cases reported in some hospitals in Wuhan since December 2019 were confirmed to be “an acute respiratory infectious disease caused by a new coronavirus.”
The above statement was also included in the second edition of the document, issued on Jan. 18—two days before Zhong’s announcement.
The second edition,… was previously kept secret. … marked …: “not to be disclosed.”
The second edition contains a section explaining that medical personnel in hospital departments dealing with patients with fever, respiratory problems, and infectious diseases should wear a surgical mask, goggles, and one-time-use protective clothing.
Despite such instructions, showing that central authorities knew the virus could spread among medical staff, they kept mum until Jan. 20.
… But that day, the Wuhan Health Commission wrote on its website that the “risk of human-to-human infection is low.”
The World Health Organization (WHO) also initially repeated China’s claims… “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,” the WHO tweeted on Jan. 14.
A recent report by the Associated Press, also citing a series of internal memos, similarly found that Beijing knew of the virus’s transmissibility for six days before publicly admitting it on Jan. 20.
It took another two days before the WHO mission to China issued a statement confirming that “human-to-human transmission is taking place in Wuhan.”