Fail-Safe System ... Failed

The New York Times piece "China Created a Fail-Safe System to Track Contagions. It Failed" is outside their paywall (maybe only temporarily).

It has a lot of new details about what went wrong in China in January. Most of the linked documents are in Mandarin.

Scarred by the SARS epidemic that erupted in 2002, China had created an infectious disease reporting system that officials said was world-class: fast, thorough and, just as important, immune from meddling.

 But it failed:

The central health authorities first learned about the outbreak not from the reporting system but after unknown whistle-blowers leaked two internal documents online.

 “According to the rules, this of course should have been reported,” Yang Gonghuan, a retired health care official involved in establishing the direct reporting system, said in an interview. “Of course they should have seized on it, found it, gone to understand it.”

 Yeah! Free press:

During a rare burst of relative transparency early in the epidemic, Chinese journalists did much to expose the problems, but censors closed that window.

But reports ran into the pyramidal structure of China's bureaucracy:

... Over time, hospitals often came to defer to local health authorities about reporting troublesome infections, apparently to avoid surprising and embarrassing local leaders.

That deference may not have mattered much most of the time. Now it gave officials in Wuhan an opening to control and distort information about the virus.

Local disease control offices in the city had counted 25 such cases by Dec. 30 ...

“The local health administration clearly made a choice not to use the reporting system,” said Dali Yang, a professor of political science at the University of Chicago who studies policymaking in China. “It is clear they were trying to resolve the problem within the province.”

 It was a joke in Men In Black, but it was reality that Beijing found out from alternative sources:

Word of the outbreak started to reach disease control officials in Beijing after rumors and the leaked documents began to spread online. The national center for disease control has pointedly avoided saying in announcements that it had been notified by Wuhan, instead noting that it had “learned of” the outbreak.

Then the foot dragging really began: 

When the central government became involved, local officials outwardly welcomed the expert investigators sent by Beijing. Officials described the infections as nothing too serious.

“They said that the illness was quite light, not much different from seasonal influenza, and there’d been no illnesses among hundreds of people with close contact,” Zeng Guang, a Chinese epidemiologist who visited Wuhan on Jan. 9, said of his talks there, according to the China Youth Daily. “They sounded very relaxed.”

Behind the scenes, officials in Wuhan mounted an effort to limit the number of infections counted as part of the outbreak, creating barriers against doctors filing cases.

A leaked report from Wuhan Central Hospital describes how in the first half of January local officials told doctors that cases had to be confirmed by bureaucratic overseers, above all, city and province health authorities.

 That goes a long way towards explaining the plateau at 41 cases for much of early January. 

Kind of interesting how, in the two largest economies in the world, foot dragging by bureaucrats who reported to the executive were the problem.