China knew the coronavirus would become a pandemic in mid-January, but for 6 days claimed publicly there was 'no evidence' it could spread between humans

• China knew the novel coronavirus could spread between humans and would become a pandemic, but didn't tell the world for six days.
• In a damning memo of a January 14 call, obtained by The Associated Press, Ma Xiaowei, head of the National Health Commission, warned top officials the virus can transmit between humans and that a pandemic is coming.
• But in the six intervening days China publicly said all was well, and said there was "no evidence" of human-to-human transmission.
• The World Health Organization (WHO) relied on that advice to direct policy and advice that other countries relied on.
• President Xi Jinping finally warned of the severity of the virus on January 20, the same day a top Chinese epidemiologist admitted human-to-human transmission.
• The report appears to substantiates criticism aimed at the WHO by President Donald Trump, who accused the body of failing to vet China's data sufficiently.
• Visit Business Insider's homepage for more stories.

For six days in mid-January, China quietly knew the novel coronavirus would become a deadly pandemic, while telling the world there was nothing to fear, according to a new report by the Associated Press (AP).

"Prepare for and respond to a pandemic," Ma Xiaowei, head of the National Health Commission, told provincial leaders on a confidential phone call on January 14, a memo of which was obtained by the AP.

"Human-to-human transmission is possible," said Ma, who used the call to convey direct orders from President Xi Jinping, according to the AP.

But in the six days that followed, Chinese health authorities publicly maintained that the virus posed a low risk to humans.

The Wuhan Health Commission announced on January 14 - the same day as Ma's call - that they "have not found proof for human-to-human transmission."

Shortly after, Li Qun, head of the Chinese Center for Disease Control and Prevention's (CDC) emergency center, told state TV that the risk was "low," the AP reported.

And at the time, the World Health Organization took China at its word, offering the same advice to countries around the world. The WHO relies on countries providing them with their own data.

"Investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission," the WHO tweeted on January 14.

The WHO did not immediately respond to Business Insider's request for comment.

At the time, South Asian countries had been looking for - and heeding - WHO guidance on how to prepare for the coronavirus, which had already spread to Thailand.

Governments around the world were also considering which preventative measures to put in place, and had their eyes glued to China's response. And for six days, the Chinese government suggested there was nothing to do.

Only on January 20 did Xi finally warn people to practice social distancing and avoid travel. The same day, Chinese epidemiologist, Zhong Nanshan, told state TV that the virus was in fact transmitting from human to human.

In the preceding six days, around 3,000 people caught the coronavirus in China, according to estimates from the AP. This period also marked the runup to Lunar New Year, the biggest holiday in China, when millions of people around the country traveled home by train and plan to see their families.

If, on January 14, Chinese authorities had told people to stay home when possible, enforce social distancing, wear masks, and refrain from travel, then there could be 66% fewer cases, according to a March 13 paper led by scientists at the University of Southampton in the UK. The paper has not yet been peer reviewed.

"If they took action six days earlier, there would have been much fewer patients and medical facilities would have been sufficient," Zuo-Feng Zhang, an epidemiologist at the University of California Los Angeles, told the AP. "We might have avoided the collapse of Wuhan's medical system."

On January 14, China had reported 224 cases of the coronavirus, but experts predict that number was substantially higher.

On January 17, Wuhan had officially reported 50 cases, but that number was likely 35 times higher, according to retrospective modeling from Imperial College London.

The first coronavirus case outside China - reported January 13 in Thailand - was what prompted the government to take internal steps to stop the outbreak on January 14, the AP reported.

That case had spooked Chinese officials, but apparently was still not enough to alert the WHO.

As early as December 6, doctors in Wuhan had started raising concerns that people could catch the virus from other humans. The most famous of these was Li Wenliang, who began sharing ominous data with fellow doctors.

Li was silenced by police in Wuhan and made to sign a confession where he admitted to lying. He later died of the coronavirus, prompting a flurry of online protests against state censorship.

As Wuhan authorities squashed Li's warnings, Chinese health authority was quietly mobilizing.

On January 15, on Ma's instructions, China's CDC initiated the "level one" response, the most extreme internal government response level.

In the following week, Chinese CDC officials were dispatched across the country to train health workers, accrue funds, collect all available data on the virus, and supervise lab testing, according to the AP. Airports in Hubei province, where Wuhan is located, were told to check people's temperatures.

But outside this bubble, China's one billion residents and the rest of the world went about their lives as normal, unaware of the looming disaster.

President Donald Trump has repeatedly accused the WHO of dropping the ball on the coronavirus crisis and of insufficiently scrutinizing China's response.

Trump pulled $400 million in annual funding for the WHO on Tuesday, saying it "willingly took China's assurances to face value ... and defended the actions of the Chinese government, even praising China for its so-called transparency," he said.

Indeed, WHO officials have consistently praised China's actions in tackling the crisis.

On January 29, WHO director general Tedros Adhanom Ghebreyesus said of China "actually helped prevent the spread of coronavirus to other countries."

That same day Michael Ryan, executive director of the WHO Health Emergencies Program, said: "China is doing the right things. We've seen no obvious lack of transparency."

Throughout the crisis authorities in China have sought to censor information about the coronavirus, silencing journalists, doctors, and content on the internet critical of the state.

The WHO ruled the coronavirus was a pandemic on March 11.

As of Wednesday, more than 127,000 people have died, and more than 2 million people have been infected.

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