New Diseases and National Transparency: Who Is Measuring Up?

I’m still catching up on all the news that happened during the weeks I was away, and I had a food-policy post just about set to go today. And then this happened.

I opened my morning mail to find a note from a private list I subscribe to, published by a company that monitors hazards for businesses with expatriate employees. The note flagged new news from Saudi Arabia:

Saudi Arabia: Seven more case of novel coronavirus reported
Seven people in Al-Ahsa governate in the Eastern province have been confirmed infected with the novel coronavirus. Five have died and the other two are critically ill in intensive care. It is unclear whether there are any links between these cases or whether they are “sporadic” infections. Overall the risk to travellers remains low.

This was odd. You’ll remember the new coronavirus, distantly related to SARS, which surfaced last year in a slow and not well-disclosed manner (for the back story, see these posts from last September, October, November and December). Since the initial reveal last year, there has been very little information released about the virus and whatever illness it might be causing. The World Health Organization has been monitoring the gradual accumulation of cases, but there has been almost nothing published since last fall. In fact, though teams from Columbia University and the Centers for Disease Control and Prevention have been to the Kingdom of Saudi Arabia to help investigate the new illness, neither entity has published anything since those trips were made. And at the point at which I opened my inbox this morning, the WHO’s last update on the new virus had been published on March 26.*

Meanwhile, of course, the infectious disease world has been riveted by the rapid emergence in China of a different virus, the new avian flu H7N9, and many questions have been aimed at whether the Chinese government, which attempted to conceal the emergence of SARS 10 years ago, has learned the lesson of transparency. (I talked about that history, and how the world found out about SARS, in this segment from On the Media a few weeks ago.)

Almost since H7N9 emerged in March, though, the WHO and other bodies have been averring that China is actually doing a good job this time around. And with this overnight news from Saudi, it seems that the questions about disease-outbreak transparency may have been directed at the wrong country.

After getting onto Twitter, I discovered that several other journalists (Martin Enserink, Helen Branswell) were also wondering where this had come from. The source for the report I received, and for things they had heard from their sources, seemed to be a Saudi Ministry of Health announcement that was published in Arabic at 10:30pm Riyadh time last night (which given daylight savings’-type time changes is currently 9:30pm in Geneva, WHO headquarters). By mid-afternoon Saudi time today (noon Geneva time, 6 a.m. in the eastern US), the news service Al Arabiya had put up a story which said basically the same thing as the original announcement.

Judging by the Twitter traffic, though, the WHO had not been informed of the Saudi announcement in advance. This is problematic because the cases were obviously not brand new — after all, five of them had already died — and it is supposed to be a government’s responsibility, under the mutually agreed-to International Health Regulations, to quickly forward any information about large or novel disease outbreaks of cross-border concern.

By this afternoon, WHO had caught up to the surprise announcement, issuing an update which adds these cases to the global count: 24 lab-confirmed cases in five countries, of whom 16 have died. Just to underline that math: Yesterday, the case count was 17. With this announcement, it went up 40 percent overnight.

By midday their time, Gulf-region media, including the Saudi Gazette and Al Jazeera, along with The National in the neighboring United Arab Emirates, had fleshed out the story. Those reports added a few key details: The victims had all been treated in a single hospital “over the last few days.” And by midday East Coast time, Helen Branswell had a story up at CBC News, featuring the WHO sending a not-very-coded message to the Kingdom’s government:

Dr. Keiji Fukuda, the WHO’s assistant director general for health security and the environment, said the WHO was informed of the cases late Wednesday, but has been given little information about them. It has asked for more, Fukuda said in an interview with The Canadian Press.

“As a matter of course we would prefer to hear and know about things as early as possible. The whole aim of detecting [diseases] is really to try to move and protect as quickly as possible,” Fukuda said from Geneva.

“I won’t speak for the government of Saudi Arabia, but I can speak for WHO in saying that it’s a point that we have made and it’s a position that we hold very clearly with everybody.”

There has been no more comment on the Saudi Ministry of Health’s site so far.

This is obviously a story that is going to continue for a while (in a slow way, one hopes, and not as a burgeoning epidemic). But this is not how the post-SARS International Health Regulations, to which the Saudi government is a signatory, were supposed to work. And it is rather odd to be watching the daily mass scrutiny of the news from China, and not see the same prosecutorial skepticism directed at this outbreak too.

*(Adding for accuracy: The March 26 post is in the Disease Outbreak News section of the WHO website, their usual spot for rapid outbreak updates. I missed though that the Global Alert and Response team published a “summary and literature review” on a separate section of the WHO site on April 25 .)





Leave a Reply

Your email address will not be published. Required fields are marked *