Can you trust the World Health Organization as you make key decisions about where and whether to travel or immigrate?

This has proved to be a life-and-death question in the worst of cases and a severe health matter in the best of cases. As we try to find the answer to the question of how trustworthy the WHO is in terms of keeping us informed regarding COVID-19, you should realize an important if difficult point:

We still don’t completely understand COVID-19 nor precisely how it can spread and who might be most vulnerable.

We have increasing amounts of data around the world on these questions, data that is being studied and analyzed as you read these words. And doctors and scientists have a much better understanding than just a few months ago. But this is a new variant of coronavirus - previous examples of which are MERS about 6 years ago, and SARS over 15 years ago - and it will be some time before COVID-19 is fully understood.

It will also be some time before a palliative (a medication that helps patients deal with the symptoms but does not cure the virus) is found. And even more time before a safe and effective vaccine is found.

So, given this context, how did the World Health Organization handle the available information in the early days of COVID-19, just as 2020 was beginning?

The answer to this depends on how skeptical one is of China’s data on the total number of infected people in the enormous East Asian country. And one key factor is how many people left the city of Wuhan and travelled to other locations around China, just before the lockdown in late January (around the 24th of January 2020). Using conservative estimates, a paper at the American Enterprise Institute (AEI) comes up with the following calculations:

COVID-19 Numbers in China

What Scissors, the author, did was estimate (with conservative rates of infection) how quickly COVID-19 might have actually spread in China before the lockdown was put in place. To do this, he compared figures with Italy, where after 21 days of unrestricted circulation, 130,000 Italian residents and/or citizens had become infected. If you adjust for population, then given that there was at least 21 days of free circulation in China during the first 3 weeks of January, it is more likely that around 2.9 million people in China were infected with COVID-19, according to Scissor’s estimate.

China’s official figures for total number of COVID-19 cases in their country is 83,249 with 3,344 deaths according to WHO’s dashboard at their website as of April 9, 2020.

2.9 million cases. Or 83,249 cases.

Who do you believe? (Sorry.)

This matters greatly for a number of reasons:

  • While Chinese scientists and doctors have provided key data – like DNA analysis of the virus – that will help find a vaccine and/or other ways of treating patients already infected, if they have been unforthcoming with some of the data, how can any figures or facts they release be trusted?
  • We need widespread, effective testing (as in South Korea for example) to understand what the true rate of fatalities is. If far more people are infected than we realize because they have no symptoms (asymptomatic) or very mild symptoms that are similar to flu, then COVID-19 is less fatal than we believe it to be and more people may be developing immunity to the disease.
  • If the data is untrustworthy then the statistical models used to predict how COVID-19 will evolve over the coming weeks and months will not produce accurate results because they are based on faulty data.
  • If the statistical models are wrong, then maybe lockdowns are not as helpful as thought because the disease has already spread quickly around the world to a much greater extent than we realize. While that might seem a scary thing, it would actually be encouraging because it would help us focus on the truly vulnerable (like older patients with pre-existing conditions) and allow a partial lifting of the curfews and lockdowns.

In other words, as many analysts and academics are saying: we need better data.

 

The Role of the World Health Organization in Coronavirus/COVID-19 Data

WHO Headquarters © Yann Forget / Wikimedia Commons / CC-BY-SA.

by Yann Forget / Wikimedia Commons / CC BY-SA 3.0

So, the next question is: is the World Health Organization doing its utmost to ensure that data from around the world, including China, is accurate and trustworthy?

This is where things get tricky because they risk being politicized. On the one hand, critics of China accuse them of silencing whistleblowers who were warning about the disease in late December. On the other hand, policy blunders in many countries around the world, including in Europe and North America, meant too little was done too late and these countries were unable to contain COVID-19 in their own homes, so to speak. And in the USA as well as in Canada and some European countries, the pandemic risks becoming the mother of all partisan issues, with views about the how to handle depending on what side of the political divide you happen to fall on rather than the science.

Medically and scientifically, that would be a disaster.

As well, the WHO is accused by critics of being too cautious with China and not pushing them to reveal more data, while the organization itself seems to state that they work with partners around the globe to help improve health systems and provide better care no matter with who or where they may be working.

Furthermore, WHO officials in January of this year, advised against a travel ban on people coming from China and even suggested that the virus might not spread easily between humans, having jumped from animals to humans sometimes late in 2019.

Both of these were clear errors on the part of WHO, but the question is whether they had enough data back in January to have made better decisions. Clearly, some people insist they did as they insist the Chinese government also had that data.

Finally, the WHO delayed calling COVID-19 a pandemic until March 11, and that was clearly a mistake, but one shared by many Western governments.

Again, this points to how difficult it is to make health policy and to set up emergency measures when the virus in question is a new and (back in late December and early January) unknown variant of the coronavirus.

 

What Should You Do?

So, how can someone trying to plan a trip or trying to put together a plan to immigrate to somewhere like Canada make sense of this? Here are a few guidelines to think about:

An epidemiological model is not meant to give a fixed prediction about the future. When a study makes a prediction, they give a range of possibilities, but those ranges depend on what we (individuals and states and other organizations) do in response. Here’s what Zeynep Tufekci wrote in The Atlantic:

When an epidemiological model is believed and acted on, it can look like it was false. These models are not snapshots of the future. They always describe a range of possibilities—and those possibilities are highly sensitive to our actions.

This means that the numbers you hear on the newscast are estimates of what could happen, but they depend on what policies are followed. So, these estimates will change for a number of reasons, including:

  • Better data shows unexpected trends,
  • Actions taken in response to these models produces different results – social distancing and lockdowns contain the spread, for example,
  • A virus often evolves – sometimes quickly – meaning that it might spread faster, or slower, or even die out. Any of these would cause a drastic change in the numbers of cases and fatalities we observe.

In other words, as someone planning a trip or planning to immigrate you are likely going to have to make your decision based on incomplete and changing information. What you do know, of course, is what kind of travel restrictions are in place in Canada, as we have informed you of in recent blogs. For now, your ability to move freely is most likely restricted and will remain so for at least some time.

As well, following the social distancing recommendations or regulations is common sense, as is considering wearing a protective mask which can help to a certain extent at least. Good hygiene with careful washing of hands and the use of gel alcohol is also something you should be doing many times a day. And being aware of how vulnerable you or close family and friends might be depending on medical conditions and age is something everyone should consider.

 

Finally, being reasonably skeptical of official numbers from organizations like WHO is fine, as long as you don’t fall into the conspiracy theory trap – whether it’s about the American military supposedly bringing the virus to China, or whether it’s about a Chinese plan to release a germ to wipe out their competitors. These kinds of extreme speculations do nothing in our battle against the virus and even help spread panic and division.

Stay patient and be flexible in your plans. You really don’t have much of a choice right now. And as always, stay as safe as you can.


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