Is the China virus count too low?
Some say early victims of the coronavirus are not being counted in the official toll
Beijing: Chen Min was healthy when she and her husband boarded a train from Hankou station in Wuhan at the end of December, headed for a trip to the southern coastal city of Xiamen. When the 65-year-old developed a persistent cough and fever a week later, she assumed it was just a common cold.
But the cold didn't get better, and the fever didn't break. So she visited Wuhan Tongji Hospital again and again. On Jan. 15, she was isolated in the infectious diseases unit. She was dead within six hours.
Although Chen had all the symptoms of the coronavirus that is spreading across China and beyond, she does not appear on the official list of nine people who have died as a result of the infection. Her death certificate, which her family showed to The Washington Post, reads "severe pneumonia."
But hospital staff told her son, Hui Xijia, that they strongly suspected she had "that" kind of pneumonia. At the crematorium, where the staff were in hazmat suits, Chen's body was incinerated immediately without a proper farewell, and the vehicle it arrived in was disinfected.
"My mother was warmhearted, and she was generous in helping people," Hui, 40, an architect who lives in Shanghai, said. "She had many friends everywhere. How pitiful that in the last mile of her journey, she had only a dozen family members saying goodbye to her in such a hurry."
Hui and his siblings believe that their mother had the coronavirus.
Tellingly, the family has received no bill from the hospital - consistent with the authorities' pledge to cover the costs of all those infected with the mysterious virus, which started in a food market where wild and exotic animals were being sold for consumption.
Chen had never been to the market, Hui said, but she did go to the nearby station to catch the train to Xiamen.
She was never given a test to categorically confirm whether it was the virus. Nor was her daughter-in-law, who cared for Chen and now has low-grade symptoms. Her husband and elder son have not been tested, either. Now Hui, having returned to Shanghai, has quarantined himself from his wife and son, lest he also be infected.
Hui's account, along with others that have emerged in recent days, suggest that the coronavirus could be far more prevalent than Chinese health authorities have acknowledged.
Official status
China's National Health Commission said Wednesday that more than 440 people have now been infected by the virus and that nine, all elderly or with an existing illness, have died.
After playing down the prospects of the pneumonia-like virus being transmitted between humans, authorities have now said that the infection of people who have never been to the market at the epicenter of the outbreak shows that it is being passed among people.
As the coronavirus has progressed, the National Health Commission has been making an effort to put out daily updates, although they often come after midnight.
But many here are wondering if the government is being as transparent about the virus as it claims to be.
China paid a steep price during the SARS crisis due to bureaucracy and red tape and can't afford to go through that again.
Memories of the attempts to downplay and cover up the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2002 still linger. The official response to more recent health scandals, from a contaminated milk scandal in 2008 to a tainted vaccine scandal in 2018, have not engendered greater confidence in the system.
China has learned the lessons of the SARS epidemic, said Mao Shoulong, a renowned professor and director of public administration at Renmin University.
"China paid a steep price during the SARS crisis due to bureaucracy and red tape and can't afford to go through that again," Mao said. "Rather than relying on a sloppy system centered around government officials, we need one that gives priority to patients, doctors and public health in an emergency like this."
Chinese leader Xi Jinping has also become involved in the response effort, on Monday issuing a directive to "put people's safety and health as the top priority and take effective measures to curb the spread of the virus." This order was emblazoned across state media.
"With the strong leadership of the Communist Party of China Central Committee with Comrade Xi Jinping at its core," experts were confident that they could control the epidemic, National Health Commission Vice Director Li Bin told reporters Wednesday.
Xi's association with the response marked a sharp contrast to the official response to the swine flu outbreak that erupted last year and caused meat prices to spike ahead of politically sensitive holidays. At that time, that crisis was handled by the prime minister and other economic officials.
Yan Jirong, a professor at Peking University's Institute of Political Development and Governance, said it was not surprising that Xi has put his name on the response.
"It has become too massive and grave an issue to be ignored," Yan said. "We have learned a lesson [from SARS] so many years back, so now we could draw from that experience and get more transparency. There's no denying that the Chinese government has made progress and managed to get sustained trust from the people.
Still, there is plenty of evidence that the Communist Party is trying to control the narrative.
Chinese media have said that the first case of viral pneumonia in Wuhan was reported on Dec. 8, but the local government did not put out an official notice about it until Dec. 31.
Then, local authorities appear to have delayed further announcements underscoring the danger of the virus until after Hubei province, of which Wuhan is the capital, had wrapped up a political meeting held from Jan. 11 to 15.
Some local journalists have said they were stopped from reporting about the virus, and even social media posts from government departments were deleted with hours.
There have also been other reports of people, in addition to Chen, who appear to have died in the coronavirus outbreak but are not included in the official tally.
Both of Xu Xinlei's parents died nine days apart in Wuhan from "lung infections" that she believes were coronavirus.
Her 72-year-old mother was hospitalized in mid-December for a heart problem and developed a fever while admitted. She was moved to the respiratory department, then quarantined. She died on Jan 12, Xu told Beijing News.
Xu's father, who had been visiting his wife in the hospital, then grew short of breath. When a scan showed he had a lung infection, doctors told Xu to move him to one of "those" hospitals, she said, referring to the institutions treating patients with coronavirus.
He died Jan. 21. Neither of them were tested for the virus. Both, like Chen, were cremated immediately.
This outbreak is extremely sensitive for Xi and the ruling Communist Party. Not only is the coronavirus spreading, but it comes on the heels of rising food prices overall and a slowing economy, in the midst of continuing frictions with the United States, and as Beijing faces political challenges in Hong Kong and Taiwan.
That means it could have political ramifications.
"People are getting very angry in Wuhan, but before, it was a local issue," said Dali Yang, a political scientist at the University of Chicago. "Now that the virus has escaped Wuhan, it has become a national issue. So, given how centralized the system is, Xi has to act decisively and put his imprimatur on this."
Xi's involvement could hearten some people, Yang said, and help local leaders ensure social stability. But this could backfire on him if the situation turns out to be worse than currently thought, or if it has a big economic impact.
Some of this impact may take time to see.
China's local governments, including Wuhan city and surrounding Hubei province, are being crushed by huge debt loads, and the financial toll of this outbreak could push them over the edge. Hubei authorities on Wednesday asked the central government for emergency assistance of 40 million surgical masks, 5 million protection suits and 5,000 infrared thermometers.
"If the disease was spread to some of the poor provinces that are heavily indebted, it would mean substantial additional outlays for local governments, especially at the municipal and county level where the budget is really, really strapped," said Victor Shih, an expert on China's political economy at the University of California at San Diego.
That may mean that promised bridges and roads will not be built, he said, adding to percolating discontent about the slowing economy.
"Even if people are unhappy, they're obviously not going to rise up or anything," Shih said.
The increasingly iron-fisted Xi, who has scrapped term limits so can theoretically rule this one-party state for the rest of his life, has put in place strict controls and surveillance to make sure there is no dissent.
"But if the disease continues to spread in China, and if we see clear signs of policy failures to deal with this kind of virus," Shih said, "I think the educated public will be very disappointed and disillusioned about the effect of concentrating so much power in the hands of one person."