Several months before the coronavirus pandemic began, US President Donald Trump’s administration eliminated a key US public health position in Beijing intended to help detect disease outbreaks in China, Reuters has learned.
The American disease expert, a medical epidemiologist embedded in China’s disease control agency, left her post in July last year, according to four sources with knowledge of the issue.
The first cases of the new coronavirus might have emerged as early as November, and as cases exploded, the Trump administration last month chastised China for censoring information about the outbreak and keeping US experts from entering the country to help.
“It was heartbreaking to watch,” said Bao-Ping Zhu, a Chinese American who served in that role, which was funded by the US Centers for Disease Control and Prevention, between 2007 and 2011. “If someone had been there, public health officials and governments across the world could have moved much faster.”
Zhu and the other sources said the US expert, Linda Quick, was a trainer of Chinese field epidemiologists who were deployed to the epicenter of outbreaks to help track, investigate and contain diseases.
As a US CDC employee, Quick was in an ideal position to be the eyes and ears on the ground for the US and other countries on the coronavirus outbreak, and might have alerted them to the growing threat weeks earlier, they said.
No other foreign disease experts were embedded to lead the program after Quick left in July, the sources said.
Zhu said an embedded expert can often get word of outbreaks early, after forming close relationships with Chinese counterparts.
Zhu and the other sources said Quick could have provided real-time information to US and other officials around the world during the first weeks of the outbreak, when they said the Chinese government tamped down on the release of information and provided erroneous assessments.
Quick left amid a bitter US trade dispute with China when she learned her federally funded post, officially known as resident adviser to the US Field Epidemiology Training Program in China, would be discontinued as of September, the sources said.
The US CDC said it first learned of a “cluster of 27 cases of pneumonia” of unexplained origin in Wuhan, China, on Dec. 31.
Since then, the outbreak of the disease known as COVID-19 has spread rapidly worldwide.
During a press briefing on Sunday shortly after this story was first published, Trump dismissed the report as similar to other stories regarding the US CDC that he described as “100 percent wrong,” without addressing whether the role had been eliminated.
US CDC Director Robert Redfield said that the agency’s presence in China “is actually being augmented as we speak,” without elaborating.
In a statement to Reuters before the report was published, the US CDC said the elimination of the adviser position did not hinder Washington’s ability to get information and “had absolutely nothing to do with CDC not learning of cases in China earlier.”
The agency said its decision not to have a resident adviser “started well before last summer and was due to China’s excellent technical capability and maturity of the program.”
The CDC said it has assigned two of its Chinese employees as “mentors” to help with the training program. It did not respond to questions about the mentors’ specific role or expertise.
The CDC would not make Quick, who still works for the agency, available for comment.
Asked for comment on Chinese transparency and responsiveness to the outbreak, the Chinese Ministry of Foreign Affairs referred reporters to remarks by spokesman Geng Shuang (耿爽) on Friday.
Geng said the country “has adopted the strictest, most comprehensive, and most thorough prevention and control measures in an open, transparent, and responsible manner, and informed the [WHO] and relevant countries and regions of the latest situation in a timely manner.”
One disease expert said he was skeptical that the US resident adviser would have been able to get earlier or better information to the Trump administration, given the Chinese government’s suppression of information.
“In the end, based on circumstances in China, it probably wouldn’t have made a big difference,” said Scott McNabb, who was a CDC epidemiologist for 20 years and is now a research professor at Emory University. “The problem was how the Chinese handled it. What should have changed was the Chinese should have acknowledged it earlier and didn’t.”
US Health and Human Services (HHS) Secretary Alex Azar on Friday said that his agency learned of the coronavirus in early January, based on Redfield’s conversations with “Chinese colleagues.”
Redfield learned that “this looks to be a novel coronavirus” from Chinese Center for Disease Control and Prevention Director Gao Fu (高福), according to an HHS administration official, who spoke on condition of anonymity.
“Dr Redfield always talked to Dr Gao,” the official said.
The HHS and CDC did not make Azar or Redfield available for comment.
Zhu and other sources said that US leaders should not have been relying on the China CDC director for alerts and updates.
In general, officials in China downplayed the severity of the outbreak in the early weeks and did not acknowledge evidence of person-to-person transmission until Jan. 20, they said.
After the epidemic exploded and China had imposed strict quarantines, Trump administration officials complained that the Chinese had censored information about the outbreak and that the US had been unable to get US disease experts into the country to help contain the spread.
Azar told CNN on Feb. 14 that he and Redfield officially offered to send a CDC team into China on Jan. 6, but still had not received permission for them to enter the country.
“Dr Redfield and I made the offer on January 6th — 36 days ago, 60,000 cases and 1,300 deaths ago,” Azar said. “We made the offer to send the CDC experts in to assist their Chinese colleagues to get to the bottom of key scientific questions like, how transmissible is this disease? What is the severity? What is the incubation period and can there be asymptomatic transmission?”
Days later, the WHO secured permission to send a team that included two US experts. The team visited between Feb. 16 and Feb. 24. By then, China had reported more than 75,000 cases.
On Feb. 25, the first day the US CDC told the US public to prepare for an outbreak at home, US Secretary of State Mike Pompeo accused China of mishandling the epidemic through its “censorship” of medical professionals and media.
Relations between the two countries have deteriorated since then, as Trump has labeled the coronavirus the “Chinese virus.”
The decision to eliminate Quick’s job came as the US CDC has scaled back the number of US staffers in China over the past two years, the sources said.
“We had already withdrawn many technical public health experts,” the same expert said.
However, the US CDC disputed that staffing was a problem or that its information had been limited by the move.
“It was not the staffing shortage that limited our ability,” it said.
The US CDC team in Beijing now includes three US citizens in permanent roles, an additional American who is temporary and about 10 Chinese nationals, the agency said.
Of the Americans, one is an influenza expert with expertise in respiratory disease.
The CDC team, aside from Quick, was housed at US embassy facilities.
No US CDC staffer besides Quick was embedded with China’s CDC, the sources said.
Infectious disease experts who spoke with Reuters said the US could still use people such as Quick with contacts on the ground in China, especially if fears of a second wave of infections materializes.
Former US CDC director Thomas Frieden said that if the US resident adviser had still been in China, “it is possible that we would know more today about how this coronavirus is spreading and what works best to stop it.”
George Conway, a medical epidemiologist who knows Quick and had served as resident advisor between 2012 and 2015, said funding for the position had been tenuous for years, because of a perennial debate among US health officials over whether China should be paying for funding its own training program.
Yet since the training program was launched in 2001, the sources familiar with it say, it has not only strengthened the ranks of Chinese epidemiologists in the field, but also fostered collegial relationships between public health officials in the two countries.
“We go there as credentialed diplomats and return home as close colleagues and often as friends,” Conway said.
In 2007, Robert Fontaine, a CDC epidemiologist and one of the longest-serving US officials in the adviser’s position, received China’s highest honor for outstanding contributions to public health due to his contribution as a foreigner in helping to detect and investigate clusters of pneumonia of unknown cause.
However, since last year, Frieden and others said, growing tensions between the Trump administration and China’s leadership have apparently damaged the collaboration.
“The message from the administration was: ‘Don’t work with China, they’re our rival,’” Frieden said.
Trump’s re-election campaign sent out a statement on Sunday evening dismissing controversy about the US CDC’s cut as a matter of politics.
“Democrats are eager to politicize the coronavirus crisis and weaponize it against President Trump, the statement said. “In so doing, they’re siding with the Chinese and providing cover for Beijing’s cover-up.”
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