This time, rather than covering up the crisis for months, authorities have been faster to report the nine cases of infection by H7N9—although there was still an unexplained lag of several weeks. Crucially, China has provided the gene sequence of the virus and other information to the World Health Organization and neighboring countries. “It’s a night and day difference,” said Laurie Garrett a global health fellow at the Council on Foreign Relations, in an interview. “I think [Chinese authorities] are far better today.”
Since SARS, China has had a lot of practice handling public health scares more openly. In 2007, China shared with the WHO virus samples of H5N1, another form of bird flu that’s usually deadly to humans, while Indonesia refused. In 2008, the government issued a nationwide health alert over hand, foot and mouth disease, an intestinal virus that killed 353 people that year.
“We have to give some credit,” says Huang Yanzhong, director of Seton Hall University’s center for global health studies. He said authorities may even have a tendency now to overreact; during the 2009 global swine flu outbreak, scores of Chinese residents and visitors were unnecessarily quarantined.
“On the research front, they are very cooperative and open,” says Mark Smolinski of the Skoll Global Threats Fund, noting that China is a member of networks like the Mekong Basin Disease Surveillance and Asia Partnership on Emerging Infectious Disease Research.
But internal Chinese politics can still play a role. In 2009, the government did not report the first deaths from swine flu until after after the commemoration of the 60th anniversary of the Chinese communist party. And the first two deaths from H7N9 at the beginning of March weren’t made public until after the National People’s Congress, when China’s new leaders officially took power.
Moreover, the instinct to control information still remains. FluTrackers, a US-based website that operates a volunteer disease surveillance network, claims it has been the target of cyber attacks originating from China. A Sina Weibo microblog post from a doctor in Nanjing who diagnosed a woman with H7N9 was removed, and other Chinese have similarly complained that their posts have been deleted, Huang says.
Also, while officials say they found no trace of H7N9 in a batch of 34 pig carcasses from among the thousands found in a river upstream from Shanghai last month, they did not say whether they tested any live pigs. They also haven’t fully explained whether live poultry were infected, Garrett says. A blogger who said he works for the North West Agriculture and Forestry University in Shaanxi province wrote on his microblog (Weibo registration required), “Over the past year, bird flu in poultry has been the worst it’s been in 20 years….officials just don’t want to admit that.”
Still, it is clear that China has experienced a fundamental shift in its attitude towards epidemics. The state-run media agency Xinhua published an article yesterday, April 3, that took government health authorities to task for past and present failings, concluding: “If there is anything that SARS has taught China and its government, it’s that one cannot be too careful or too honest when it comes to deadly pandemics. The last 10 years have taught the government a lot, but it is far from enough.”