The Chinese Government is officially merely “suspicious” about the possibility of transmission by human contact of what has so far proven a deadly new strain of flu, according to China’s own CDC and state-run news media. The H7N9 strain of flu has reportedly killed 17 of 87 persons infected, a mortality rate of 20%. (H1N1 in 2009, by comparison, had a mortality rate in the neighborhood of 1.7 persons per 10,000 cases, or 0.0017% using CDC estimates, while the great Spanish Flu of 1918 was mortal to just under 1.8% of those infected.) It is also likely many of the people infected in China have a lower baseline health than Americans, and in the remote villages especially, lack of access to immediate and effective care, clean water, and antiviral medications, which leads to an artificially high initial mortality. Just the same, the news got decidedly worse today, despite the optimistic tone of the previous few days.
“Further investigations are still under way to figure out whether the family cluster involved human-to-human transmission,” Feng Zijian, of the Chinese Center for Disease Control and Prevention, told the newspaper.
Glenn Thomas, a spokesperson for WHO, tells U.S. News that “it’s still too early to say” whether there have been human-to-human transmission, but that the team they’ve sent there will be investigating the possibility.
“There’s no evidence yet of sustained human-to-human transmission, but the team will be looking into this,” he says.
What is not reassuring at all about the situation is memories of China’s massive cover-up of the SARS epidemic in 2002-3, during which Chinese officials denied the very existence of SARS, and of outbreak clusters for months. Chinese officials also transferred infected patients, and sometimes entire hospital populations, to keep them from World Health Organization physicians. Chinese government officials prevaricated, misled, and stonewalled, until the evidence could no longer be hidden.
Despite the embarrassment of the SARS incident, including the deadly results (most of which remained in China and virtually unreported in the world press), and the promise for more transparency, once again on this occasion the Chinese government waited close to a month to report the outbreak in Shanghai, and only on 29 March confirmed the virus as H7N9.
There are rumors of positive tests for H7N9 in asymptomatic people, suggesting a long incubation period during which a victim may be a contagious “carrier”, and there is now reports of confirmed cases among people who have not had any contact with birds or fowl. Reassurances by Chinese health officials ring increasingly hollow, as their pattern of reporting and non-reporting take on familiar and delusory tones.
I don’t know for sure, but I suspect strongly that human-to-human transmission has been all but confirmed in China for quite some time, perhaps weeks. Now, there are cases reported in Nanjing and Beijing, in addition to those around Shanghai. In the age of rapid and easy global travel, containing a deadly pathogen is all but impossible. Having to rely on Chinese transparency and honesty to have a head start is not at all good.