How China's Under-reporting of Outbreaks Undermines Its Efforts to Control Coronavirus Epidemic
How China's Under-reporting of Outbreaks Undermines Its Efforts to Control Coronavirus Epidemic
The first reported death from the virus, also known as SARS-CoV-2, came on January 9 - a 61-year-old man in Wuhan. In the following days, Chinese authorities said that the virus was under control and not widely transmissible.

When the deadly virus was first discovered in China, authorities told the people in the know to keep quiet or else. Fearing reprisal from Beijing, local officials failed to order tests to confirm outbreaks and didn’t properly warn the public as the pathogen spread death around the country.

All this happened long before China’s coronavirus outbreak, which has claimed more than 3,000 lives worldwide in less than three months. For the past 19 months, secrecy has hobbled the nation’s response to African swine fever, an epidemic that has killed millions of pigs. A Reuters examination has found that swine fever’s swift spread was made possible by China’s systemic under-reporting of outbreaks. And even today, bureaucratic secrecy and perverse policy incentives continue undermining Chinese efforts to defeat one of the worst livestock epidemics in modern history.

Beijing’s secretive early handling of the coronavirus epidemic has troubling similarities to its missteps in containing African swine fever, but with the far higher stakes of a human infection. After the coronavirus was found in December 2019 in Wuhan, the capital of Hubei province, local and national officials were slow to sound the alarm and take actions disease experts say are needed to contain deadly outbreaks. Beijing continues to gag negative news and online postings about the disease, along with criticism of the government’s response.

With swine fever, Beijing set a tone of furtiveness across government and industry by denying or downplaying the severity of a disease that the meat industry estimates has shrunk China’s 440-million-hog herd by more than half. The epidemic has taken a quarter of the world’s hogs off the market, hurt livelihoods, caused meat prices to spike globally and pushed food inflation to an eight-year high.

Cover-ups across China - coupled with underfinancing of relief for devastated pig farmers and weak enforcement of restrictions on pork transport and slaughter - have enabled the spread of the livestock virus to the point where it now threatens pig farmers worldwide, according to veterinarians, industry analysts and hog producers. Since the China outbreak, African swine fever has broken out in 10 countries in Asia.

The vacuum of credible information has made it impossible for farmers, industry and government to tell how and why the disease spread so quickly, making preventive measures difficult, said Wayne Johnson, a Beijing-based veterinarian who runs Enable Ag-Tech Consulting.

"To get it under control, you have to know where it is," Johnson said.

China’s Ministry of Agriculture and Rural Affairs said in a statement to Reuters that it has repeatedly communicated to all regions the importance of timely and accurate reporting of African swine fever outbreaks and had zero tolerance for hiding and delaying the reporting of cases.

Interviews with farmers, industry analysts and major suppliers to China’s pork sector indicate otherwise. More than a dozen Chinese farmers told Reuters they reported disease outbreaks to local authorities that never made it into Beijing’s official statistics. Those infections are going unreported to central authorities in part because counties lack the cash to follow a separate requirement from Beijing to compensate farmers for pigs killed to control the disease.

Local officials have also avoided reporting outbreaks out of fear of the political consequences. And they have routinely refused to test pigs for the virus when mass deaths are reported, according to interviews with farmers and executives at corporate producers.

A farmer surnamed Zhao, who raises a herd in Henan province, said local officials told him as much when they resisted recording the outbreak he reported on his farm, which wiped out his herd.

“‘We haven’t had a single case of African swine fever. If I report it, we have a case,’” Zhao recalled an official telling him. The local officials could not be reached for comment and a fax seeking comment went unanswered.

When the coronavirus hit, Chinese authorities reacted with a push to reassure the public that all was well. The first reported death from the virus, also known as SARS-CoV-2, came on Jan. 9 - a 61-year-old man in Wuhan. In the following days, Chinese authorities said that the virus was under control and not widely transmissible.

The assurances came despite a lack of reliable data and testing capacity in Wuhan. Testing kits for the disease were not distributed to some of Wuhan's hospitals until about Jan. 20, an official at the Hubei Provincial Centre for Disease Control and Prevention (Hubei CDC) told Reuters. Before then, samples had to be sent to a laboratory in Beijing for testing, a process that took three to five days to get results, according to Wuhan health authorities.

During that gap, city hospitals reduced the number of people under medical observation from 739 to 82, according to data from Wuhan health authorities compiled by Reuters, and no new cases were reported inside China.

China’s top leadership has dramatically ramped up the public-health response since its early missteps. Beijing built new hospitals in days to treat the sick and launched an unprecedented blockade of the disease epicenter on Jan. 23, first quarantining Wuhan’s 11 million residents at home, then suspending transport in all major cities of Hubei province, home to about 60 million people.

Still, the initial attempts to tightly control information left many people unaware of the risks and unable to take precautions that might have prevented infection - and the suppressing of news and commentary continues today. Wuhan authorities reprimanded eight people they accused of spreading "illegal and false" information about the disease. One of them, 34-year-old doctor Li Wenliang, later died from coronavirus, triggering an angry backlash on social media.

Some critical posts were allowed during a brief and unusual period of online openness in late January. But Beijing’s censors - the Cyberspace Administration of China (CAC) - have since cracked down on posts about Li and other information that authorities deem negative, according to CAC censorship orders sent to online news outlets and seen by Reuters. One CAC notice ordered online outlets to guard against “harmful information.” Another ordered them not to “push any negative story.”

The CAC did not respond to a request for comment sent by fax.

UNREPORTED OUTBREAKS

Beijing had years to prepare for African swine fever. Veterinarians have frequently warned Chinese authorities of the risks since the disease started spreading through the Caucasus region in 2007.

Pigs infected by the virus initially suffer high fever, loss of appetite and diarrhea. Then their skin turns red as internal hemorrhaging starts and their organs swell, leading to death in as little as a week.

With no vaccine or cure available for the disease, experts recommend that infected pigs and others housed in the same barn are culled, with the carcasses either burned or buried to prevent further infection. Farms, equipment and vehicles that could be contaminated need to be thoroughly cleaned and disinfected.

The first case in China was discovered on Aug. 1, 2018, on a farm near Shenyang, in the northeastern province of Liaoning. Just two weeks later, the virus was found more than 1,000 kilometers to the south in pigs bought by the country's top pork processor, WH Group, from another northeastern province, Heilongjiang. It took Beijing another two weeks to block pig exports from the whole region, and that and other transport restrictions were poorly enforced, said Johnson and other industry experts. WH Group declined to comment.

One factor behind the epidemic: Chinese consumers prefer fresh pork - straight from the slaughterhouse, rather than chilled. This means hundreds of thousands of live pigs are moved long distances every day to supply processors in major cities. That mass movement spread the disease relentlessly.

Over the first four months of the outbreak, Beijing reported swine-fever cases almost daily as the virus spread from the northeast down through central China, west into Sichuan, and to the huge province of Guangdong by year-end. Veterinarians believe the virus spread quickly because it can survive for weeks on dirty farm equipment or livestock trucks.

And yet gaps in counting and tracking the pig disease have been routine across China. Reuters found a striking absence of reported outbreaks in some of the nation’s most productive pork regions.

For instance, almost none of the reported outbreaks have come from the major hog-raising provinces of Hebei, Shandong and Henan. The three contiguous northern provinces were the source of some 20% of the 700 million pigs China slaughtered in 2017. Many came from backyard farms, which make up a large part of China's industry and have proven fertile breeding grounds for the disease. Yet each of the three provinces has reported just a single case of African swine fever, despite widespread anecdotal reports of outbreaks there that industry sources believe killed millions of pigs.

Neither Shandong nor Henan authorities responded to requests for comment. Hebei’s department of agriculture said it had “strictly reported and verified the epidemic” and that the disease situation was currently “stable.”

Six Henan farmers told Reuters they reported outbreaks during late 2018 and the first half of 2019. In some cases, local authorities helped deal with dead pigs, they said, but never tested for the virus.

That’s what happened when Wang Shuxi, a farmer in Henan’s Gushi County, lost more than 400 pigs in March 2019. Wang said he had no doubt that his pigs had African swine fever, even though authorities never tested them - and he couldn’t test them himself, because Beijing did not permit the commercial sale of disease test kits at the time.

His pigs showed telltale symptoms of the disease.

"The whole body went red,” he said. He injected the animals with an anti-fever medication to no avail. “At the start, they didn't eat, and even after injections, it kept returning,” he said. “If you can't cure it, you know it's swine fever."

Provincial and county governments had strong incentives to avoid verifying and reporting outbreaks because of Beijing’s rules on compensating farmers, said Huang Yanzhong, specialist in health governance with the Council on Foreign Relations in New York.

Under an African swine fever contingency plan drawn up in 2015, Beijing ordered the culling of all pigs on farms where the disease is found and on every farm within a three-kilometer radius. The central government raised compensation from 800 yuan ($115) to 1,200 yuan for every pig culled in 2018. Beijing typically promised to provide between 40% and 80% of the money, depending on the province. Localities would fund the rest.

In April 2019, the national agriculture ministry said the central government had allocated 630 million yuan to cull 1.01 million pigs to contain the disease. But that money either wasn’t sufficient or regularly did not get paid out, farmers told Reuters. None of about a dozen farmers who told Reuters they tried to report outbreaks said they had received the promised 1,200 yuan for each pig.

Many got nothing. Wang, the Gushi County farmer, said that almost a year after his pigs died, he has received no recompense. Gushi County officials could not be reached for comment.

Many farmers, eager to salvage value from their herds, have resorted to sending their pigs to slaughter at the first sign of illness - thereby thrusting the virus into the human food supply. The swine fever virus does not threaten people. But its presence in meat - where it can survive for weeks - creates a cycle of infection because many backyard farmers feed pigs with restaurant scraps that include pork.

Garbage feeding caused 23 outbreaks in 2018, Huang Baoxu, deputy director of the China Animal Health and Epidemiology Center, told reporters at a briefing in November that year. His remarks were a rare instance where the central government revealed findings about the spread of the hog virus. The center declined to comment for this story.

Farmers visiting slaughterhouses dealing in sick pigs also likely picked up the virus on their trucks or equipment, spreading it back to their farms, Johnson said.

In the southern province of Guangxi, the disease raged through the spring of 2019 and early summer, several farmers told Reuters last year. Bobai County was hit hard.

A Bobai farmer surnamed Huang said she lost almost 500 pigs during April and May. She said she tried to report the diseased pigs to the local government but was ignored. The official she spoke to by phone never came to her farm. He told Huang that her pigs could not be saved - but that they didn’t have African swine fever. His advice, she said: “hurry and sell the pigs while they could be sold.”

Huang said she sold more than 30 pigs that she believed had the virus. They looked healthy when she sold them, she said. Others sold obviously sick pigs at very low prices. “Traders took all the pigs, including the sick ones - as long as they could walk to the trucks,” she said.

Huang buried her dead pigs daily for weeks on a relative’s land. Others simply dumped their dead pigs on the roadside or in the mountains, she said. The government provided no help.

Eventually, in late May, Bobai County reported one pig dead from the disease, official statistics show.

Authorities in Guangxi did not respond to a request for comment, and officials in Bobai county’s agriculture bureau could not be reached.

Beijing’s agriculture ministry said in a statement that it had issued an August 2019 order requiring punishments in situations where localities failed to report outbreaks. The ministry said it meted out unspecified discipline to more than 600 local personnel for what it called failures to manage the disease that were uncovered in its investigations of problem areas.

The practice of processing infected hogs has persisted despite new rules from Beijing in July that required slaughterhouses to test all batches of pigs for the virus. The agriculture ministry said in January that 5% of the more than 2,000 samples taken from slaughterhouses in November tested positive for the disease.

An Australian study in September found 48% of meat products confiscated from Asian travelers arriving at its ports and airports contained the virus.

"It showed there's an awful lot of unrevealed infection not being reported to the authorities," said Trevor Drew, director of the Australian Animal Health Laboratory.

One such information gap is at the top of the industry - China’s large corporate pig producers. They have also been hit hard by the disease, despite taking more extensive measures than backyard farms to disinfect trucks and require workers to change clothes and shower before and after shifts.

None of China’s top publicly traded producers have publicly announced any swine fever outbreak, but executives of major hog producers acknowledged in interviews with Reuters that their herds were hit by the disease.

Thai conglomerate C.P. Pokphand , one of China's leading pig producers, has had swine-fever outbreaks on farms in Liaoning, Shandong, Henan and Jiangsu provinces, Bai Shanlin, chief executive of China operations, told Reuters in a rare admission by a listed firm. Executives at three other listed companies, also among China’s top pig producers, acknowledged outbreaks at several farms but declined to be identified.

None of the outbreaks that these large companies have confirmed to Reuters were reported by Beijing, according to a Reuters review of the agriculture ministry’s data on outbreaks.

By August 2019, a year after the first case was found in China, pork prices had passed a record set back in 2016. And they were still climbing rapidly. With a crucial national celebration approaching in October - the 70th anniversary of the founding of the People’s Republic - China’s top leaders took note. Pork is a staple of Chinese cuisine, and rising meat production has been among the many signature achievements in the Communist Party’s decades-long drive to bring prosperity to China.

In a video conference that month with officials from all 34 provinces and regions, Vice Premier Hu Chunhua issued a warning: Sufficient pork was vital to people's lives and the country's stability. He called for the urgent recovery of the herd as a key “political task.”

A raft of new production policies and incentives emerged from Beijing. And as the provinces rallied to replenish the nation’s herd, reports of African swine fever grew even more rare. Disease outbreaks reported by the agriculture ministry have tailed off since August. In January, Agriculture Minister Han Changfu said the situation has stabilized.

The government’s statistics are rife with contradictions, however. The ministry has reported 163 outbreaks of African swine fever since August 2018 and said 1.19 million pigs have been culled, a fraction of 1% of China’s total herd. Separate ministry data tracking the herd monthly show that, by September 2019, the herd had shrunk by 41% from the prior year. (For a graphic on the decline in China's pig herd, click https://tmsnrt.rs/38lkOcx )

These official estimates of the decline are far too low, three major industry suppliers told Reuters.

“It’s at least 60%,” said Johan de Schepper, managing director of Dutch feed ingredients firm Agrifirm International. His assessment, based on sales to about 100 large pig producers, echoed those of others in the industry.

The virus is still killing pigs nationwide and the herd may still be shrinking, say farmers and industry suppliers. “Half of the herd was gone before this winter, and I think half of the rest will be gone by the end of the season,” said Johnson, the veterinarian, citing conversations with clients from across China.

The problem: Some areas were hit with a second wave of the disease.

Henan province is among them, farmers told Reuters. Last year, about 60% of Henan’s herd was wiped out, mainly in the densely farmed areas in the south and west of the province, analysts at Guotai Junan Securities wrote in an internal memo seen by Reuters. Recently, the memo noted, the virus has moved through east Henan, taking out another 20%.

The vicious disease ruined Zhao, the farmer in central China's Henan province. The virus struck in October, causing high fever, internal bleeding, vomiting and diarrhea in his pigs. Just two survived. The other 196 died in a week.

When Zhao tried to report the outbreak to the county veterinary authority, he said, officials strongly encouraged him to keep quiet. A local official reminded him of the national mandate to cull all pigs within three kilometers of an infected farm. That could spell disaster for his neighbors if Zhao spoke up.

"If it's found to be African swine fever, people nearby will have to stop raising pigs," Zhao recalled a local official telling him. Zhao decided against filing a report to protect his neighbors, he told Reuters on a recent visit to his farm.

Further up the political hierarchy, the deputy governor of Henan province was quoted by the provincial agriculture bureau as saying in December that Henan had been free of the disease for 14 months, after a single reported case in September 2018. The provincial government did not respond to requests for comment.

The disinformation game continues. Zhao says that when county officials came by his farm in January, they recorded that he still had 180 pigs. In fact, he said, he had just the two hogs that survived the October outbreak.

"The country is being kept in the dark," he said.

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