Transparency in the Wake of the H7N9 Flu Outbreak: Is China Keeping its Promises?

By Katherine Sliney

Chicken

Source: Eurleif’s flickr photostream, used under a creative commons license.

Eastern China has become the epicenter of an outbreak of H7N9, a new strain of “bird flu” previously unknown to infect humans. Proven to be highly lethal, the most severe cases result in septic shock and organ failure in its victims.  As of May 1, 127 cases have been reported, 24 of which have been fatal. Chinese health authorities have closely monitored “family clusters” and others having contact with confirmed H7N9 patients, to see if the triple-mix of bird flu genes in H7N9 has undergone a key mutation enabling effective human-to-human transmission. After one asymptomatic case was found in Beijing, experts questioned if mild and symptomless cases might yet be undiscovered, bumping up the true infection count.

Last month authorities in Shanghai closed an agricultural market after a strain of H7N9 was detected in pigeons for sale. As the virus began to spread, Chinese authorities swiftly shut down live poultry trading in Shanghai, Nanjing, Hangzhou and Beijing.  Authorities culled tens of thousands of chickens, ducks, geese and pigeons, as foul were confirmed to be infected.

Widely applauded for its transparency, China’s management of the outbreak has seemed encouraging, especially in comparison to the SARS experience just ten years ago. One World Health Organization official called Chinese authorities “exemplary” in proactively sharing information on the new strain.

One encouraging change from a decade ago is the influence of micro-blogs, which have made it more difficult for the State to keep a tight lid on the spread of information. As a sign of adaptability to changing conditions, provincial governments have responded with live tweet-like updates of their own, bolstering authorities’ abilities to manage fears – and the message. Discussions of bird flu (禽流感) and “h7n9,” so far remain, on the whole, un-scrubbed by internet censors on China’s social media sites.

However, making final assessments of China’s commitment to transparency is still premature.

On February 24, the first known H7N9-positive case was admitted to a hospital – an 87-year old man living in Shanghai with his two sons, whom days later were admitted with similar pneumonia symptoms. The father passed on March 4, the day before outgoing Premier Wen Jiabao opened the annual session of China’s People’s Congress. Days after the National People’s Congress (NPC) convened, one of the family’s sons succumbed to the virus, as did a young butcher. It was not until three weeks after Xi Jinping assumed his role as President that the new strain of avian flu received its first mention in State media. Xinhua’s report assured the public that no person-to-person transmission had occurred. In reality, however, human-to-human transmission had not been ruled out.

On April 10, CCTV announced Chinese police arrested roughly a dozen people for spreading rumors about H7N9, similar to the arrests took place when the Party was still covering up the severity of the SARS epidemic. It wasn’t until a week later, on April 17 of this year, chief epidemiologist at the Chinese Center for Disease Control, Zheng Guang, admitted that in H7N9-infected family clusters human-to-human transmission had likely occurred. Did sensitive news censorship during the political transition get in the way of transparent reporting, as it had during SARS?

In 2003, it wasn’t until months after the government became aware of the first case of SARS that Chinese media publicly acknowledged information about the outbreak. While the virus silently spread, doctors were ordered not to speak about the true situation going on inside their hospitals and information regarding its spread was downplayed or outright omitted in the press. SARS was classified as “top secret,” requiring approval from senior authority prior to releasing news. SARS claimed 774 lives and infected 8,098 worldwide.

In a country easily rattled by anniversaries, China’s H7N9’s outbreak comes not only on the heels of the 10-year anniversary of SARS but also at another low point for public trust; In March 16,000 pigs were found dead floating in Shanghai’s Huangpu River – the local water supply – fueling suspicions and raising old doubts about government commitment to transparency. Oddly, reports have surfaced that the WHO recently deleted its statement denying any connection between the H7N9 virus and the dead pigs.

Time will reveal whether China and the rest of the world will successfully dodge a deadly pandemic. As for gauging if China is truly committed to transparency and lessons learned after SARS? We may only have that answer once this H7N9 outbreak is in the rear-view mirror.

Ms. Katherine Sliney is a researcher with the Freeman Chair in China Studies at CSIS.

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