Friday, April 17, 2020

WHO? What? When?

The news from 1600 Pennsylvania Avenue this week has undoubtedly led many to wonder: what exactly is the role of the World Health Organization (WHO)? In my view, the answer is...muddled.

Earlier this week, headlines screamed the US statements from on high (quoted below) accusing the WHO of negligence. In light of the dates offered in those statements, I reviewed my earlier research on the  timeline of what was known early on about the novel coronavirus, published in this blog on March 22. It gives some perspective on the accuracy of the accusations against WHO. 

POTUS statement on April 14: “The WHO failed to investigate credible reports from sources in Wuhan that conflicted directly with the Chinese government’s official accounts. There was credible information to suspect human-to-human transmission in December 2019, which should have spurred the WHO to investigate, and investigate immediately. Through the middle of January, it parroted and publicly endorsed the idea that there was not human-to-human transmission happening despite reports and clear evidence to the contrary. … The WHO pushed China’s misinformation about the virus, saying it was not communicable.”

My March 22 analysis of the timeline reveals that POTUS’ claim about “credible information... in December” is questionable. “Whistleblowers” within the medical community in Wuhan tried to warn their peers the last week in December and were shut up by local officials. WHO received the first report of a problem on December 31, from member-country China. 

It is true that, as late as January 12, WHO was falling in line with China’s claim that "there is no clear evidence that the virus passes easily from person to person." WHO did not add the words “not communicable.”

By January 19, after reports of travelers from China to Korea and Japan having contracted the virus, WHO had revised its wording: “it is possible that there is limited human-to-human transmission.” The very next day, WHO tweeted that such transmission was “very clear.” Interestingly, WHO's tweets during those crucial weeks were more dire than the "Disease outbreak news" items on its website.

This changing language is outlined in an April 17 Washington Post analysis of the POTUS statement. The Post offers its own timeline of events, and introduces a new player, Taiwan, which allegedly forwarded an email about the concerns of one of the Wuhan “whistleblowers” to WHO. POTUS appears to be seizing on that new information and putting his own spin on it, claiming that this email from Taiwan (a non-member country), sent to WHO on December 31—the same day WHO received an official, and less inflammatory, report from member-country China—should have prompted WHO to take a much closer look than it did.

The question indeed seems to be whether WHO “should have” gone into Wuhan and uncovered some tightly held facts about the expanding reach of the disease, either “in December”— even before the Wuhan whistleblowers got their message out?—or at least during the first two weeks of January. Is that a WHO role?

A look at the lengthy list of WHO disease outbreak news around the world is eye opening.

There’s a lot of disease in the world, and a lot of it is communicable. Clearly, WHO serves as an information clearinghouse, forwarding "reports" from member countries on a routine basis. Beyond that, it would be an extremely busy busybody if it actively investigated the details of each of the reports described in these dispatches. Does it do so routinely, and does it deploy medical detectives like those we are used to seeing on TV and in movies, who cleverly discover the facts despite official obfuscation and denial? That is not clear.

The WHO constitution states that member countries agree to both “cooperate” and take individual measures to ensure the health of their populations. 

Enforcing public health legislation falls under the latter. In public health emergencies, however, WHO is authorized to respond with: 

- Leadership
- Partner coordination
- Information and planning
- Health operations and technical expertise
- Operations support and logistics
- Finance and administration

Specific actions can include mobilizing in-country WHO staff, “establishing contact” with government officials, and deploying “surge support” if needed. The criteria for initiating such actions, and additional actions, are spelled out in this lengthy document.

Rather than try to analyze this complicated document, I would like to simply ask the experts. Surely the US liaison to the WHO could answer questions about its role and authority without a second’s thought. Would that be someone in the CDC? If so, it’s unlikely that individual will freely step forward to confirm, deny, or even offer explanatory background on the statements about WHO issued from 1600 Pennsylvania Avenue.

Thus, my timeline could be updated with some of the newer tidbits of information, but my perspective on what “should have” happened must remain, for now, muddled.

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