April 11, 2003
World Health Organization Headquarters, Dongzhimenwai, Beijing, China
3,130 Infected, 312 Dead
THE WHO TEAM WAS SATISFIED WITH WHAT THEY HAD SEEN DOWN south. Guangdong had, in part thanks to Zhong Nanshan’s aggressive clinical leadership and a very rapid response by the Guangdong public health authorities, done an admirable job of containing the outbreak. “The authorities in Guangdong have carried out a very detailed surveillance of the case, and the numbers reported in Guangdong do in fact represent reality,” said Mike Ryan of the WHO. If Guangdong had truly beaten the bug, the WHO team suspected, then there was hope for the rest of the world.
Yet now the team was confronted with Beijing, and the real possibility that SARS was more widespread there than previously acknowledged.
They immediately went to the leadership compound in Zhongnanhai, central Beijing, a rarefied lakeside enclave reserved for Chinese leaders and visiting dignitaries. Vice-Premier Wu Yi, the most powerful woman in the Communist Party and a protégée of former premier Zhu Rongji, greeted them in a formal reception area.
It is hard to attend such a meeting without a sense of awe and privilege. Zhongnanhai is adjacent to the Forbidden City and occupies land once the retreat of Chinese emperors and their court. It may be called the Palace of the People, but to visit this hallowed ground today is to follow in the footsteps of every courtier or envoy who ever had an audience with the Chinese court. The ranking members of the Communist Party reside within its vermilion walls, similar to those that once enclosed the Forbidden City. To be allowed to reside inside Zhongnanhai is the surest indicator that a bureaucrat or official has reached the pinnacle of Chinese power. Yet among those inside the compound, which is so secretive and carefully constructed that it is impossible to see from the outside, there is intense jockeying for prime position. Mao Tse-tung, for example, lived in one of the exclusive lakeside villas and held court in a sedan chair next to his indoor swimming pool. Deng Xiaoping took one of the villas but preferred to sleep in his immense office. High-ranking officials vie for the walled compounds on the former imperial grounds between the Middle and South lakes, preferably facing south. These former hutong-style complexes have been converted into lakeside villas, many with private swimming pools and other perquisites. Security within Zhongnanhai is tight, and even those who are allowed to live on the grounds are required to show specific passes as they go from one section to another. The WHO team was getting a rare glimpse of courtly life as they waited for Wu Yi in a massive reception hall before one of the freshwater lakes stocked with carp and rare tortoises.
Wu Yi coifs her silver-black hair in an immense, intricately curled pile, as if she has borrowed a giant’s pompadour. She wears wire-rim glasses and has a wide nose. When she listens, she purses her lips. Before speaking, she parts them once, closes them, and then talks. High-ranking Chinese officials are used to being listened to, unfamiliar with being interrupted, and unaccustomed to being questioned, making it exceedingly difficult for anyone speaking with them to raise a controversial issue.
For the meeting with the WHO team, Wu sat in the traditional seat at the northern side of the room, on her armrest a cup of tea that she did not sip. SARS had been weighing on her mind, she admitted, telling the WHO team that she hadn’t been sleeping well since the outbreak had flared up. In fact, she’d had to resort to sleeping pills. She expressed how grateful China was for the WHO’s cooperation.
The team was soon impressed with Wu’s technical grasp of the science involved. She understood very well what the issues were, and the necessity of such particulars as contact tracing and acquiring samples. She had personally dispatched teams to two provinces to investigate outbreaks and further promised improvements in China’s updates on the number of infected. For Henk Bekedam, as the head of the WHO Beijing mission, this meeting would mark the beginning of a fruitful relationship that would allow him, when necessary, to appeal directly to the highest levels of government.
Yet the team was left wondering why, if Wu Yi represented those highest levels, the government was unable to acknowledge SARS as the paramount national issue that Wu Yi seemed to be admitting it was. “What she was saying was that they were aware of the problem; they got it,” says WHO team member James Maguire. But there was something off-putting about this admission. “You realized,” says Meirion Evans, “that if the central government cared this much and still couldn’t cut through the bureaucracy in terms of implementation, then who could?”
Apparently, no one.
On April 7, when China’s new premier, Wen Jiabao, visited the national CDC offices in Beijing, the China Daily reported that Wen “stressed that China has the SARS epidemic under control.” Wen’s own comments that day were actually more telling. He said to Li Liming, head of the China CDC, in earshot of other CDC physicians and scientists: “It was wrong that the military was not reporting cases of SARS,” adding that the CDC should start telling the truth to the people.
He then pointedly asked the CDC how many people in Beijing had SARS.
“We couldn’t tell him,” said one person who was in attendance.
But even as the premier was expounding on the need for transparency, his health minister was still covering up. John Pomfret wrote that Bi Shengli, a leading virologist in Beijing, had warned a senior official in Health Minister Zhang Wenkang’s office, “We have a disaster in the capital in this new disease. We have got to do something.”
Bi was told that the minister already knew about the problem. “We have to negotiate with other ministries and government departments before anything can be done,” the ministry official told him.
“Well,” said Bi, “nothing was done.”
One Chinese official who was not directly involved with SARS would tell me that the paralysis was the result of his fellow officials’ thinking of their own careers first. “It’s not a selfish impulse,” he explained. “It becomes second nature. Minister Zhang did what came naturally: he wanted to understand the spheres of influence. He knows he can’t interfere with the military hospitals. Those are the domain of his boss and protector, Jiang Zemin. So he was paralyzed and could not really ask for that information from military hospitals.”
So far, Dr. Jiang Yanyong’s revelations concerned primarily cases in the military hospital system, which reported up a separate chain of command from the public hospitals. This failed to explain why the cases in the hospitals Huang Yong was “bombing” had been unreported. These hospitals, it would later emerge, were among those ordered by the Beijing municipal authorities to squelch information on SARS.
The WHO’s plan to quietly write and file a report on Guangdong was put on hold. Everyone now conceded that there was virus burning through Beijing. In fact, there had been for well over a month.
After Madame Wu Yi concluded, “This is a big, big problem,” WHO’s James Maguire decided to call Dr. Jiang Yanyong.
“I would be happy to talk to you,” said Dr. Jiang when he came on the phone, “but you need to get the approval of my commanding officer.”
The party boss of 301 Hospital and a fellow hospital bureaucrat had visited Dr. Jiang in his apartment on Wanshou Road and told him that he had to stop speaking to the media. From now on, all media requests had to go through the hospital president.
But after prefacing his statement with that proviso, Dr. Jiang told Maguire which hospitals the team should visit.
The WHO would now also be in the business of “bombing” hospitals.