Secrecy and cronyism at China’s main disease control agency led to a widespread shortage of tests and failures that hampered early response to the coronavirus outbreak, according to an Associated Press investigation.
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The China Center for Disease Control and Prevention awarded test kit designs and distribution rights exclusively to three then-unknown Shanghai companies with whom officials had personal ties, according to the investigation. It was based on interviews with more than 40 physicians, CDC employees, health experts, and industry insiders, as well as hundreds of internal documents, contracts, messages, and emails.
Shanghai-based companies GeneoDx Biotech, Huirui Biotechnology and BioGerm Medical Technology paid the China CDC for the information and distribution rights, according to two sources with knowledge of the transaction who requested to remain anonymous to avoid retaliation. The price: one million yuan ($ 146,600) each, the sources said. It is unclear if the money went to specific people.
Meanwhile, the CDC and its parent agency, the National Health Commission, tried to prevent other scientists and organizations from testing their own home kits for the virus. They took control of patient samples and made the testing requirements to confirm coronavirus cases that much more complicated.
The faulty testing system, at a time when the virus may have slowed down, prevented scientists and officials from seeing how fast it was spreading. Chinese authorities did not report a single new case between January 5 and 17, even as hundreds of people were infected in Wuhan, the city where the virus was first detected.
The apparent calm in the cases meant officials were slow to take early action, such as warning the public or banning large gatherings. It also led to a severe shortage of test kits, preventing access to care for many infected people.
Testing problems, along with other bugs and delays, allowed the virus to spread through Wuhan undetected and spread around the world in a pandemic that has now sickened 64 million people and killed nearly 1, 5 million.
China was not the only country that faced the tests. In the US, the CDC refused to use a WHO design and insisted on developing its own kits, which turned out to be faulty and led to even longer delays than in China. Still, the setbacks in China were especially important because it was the first country to detect the virus.
“Because there are only three companies that provide test kits, the ability to perform tests is very limited,” said Yanzhong Huang, senior global health researcher at the Council on Foreign Relations. “It was a major problem that caused a rapid increase in cases and deaths.”
China’s Foreign Ministry and China’s main medical agency, the National Health Commission, did not respond to requests for comment.
But interviews and documents suggest that a culture of secret connections quietly flourished in a top-down and underfunded public health system. Although none of the first three diagnostic companies chosen to make test kits were well known in the industry, there were extensive links between the companies and China’s top researchers at CDC.
BioGerm founder Zhao Baihui was the former chief technician of the microbiology laboratory at the Shanghai CDC. Emails and financial records obtained by AP show that Zhao started BioGerm’s predecessor through an intermediary in 2012, when he was still at the Shanghai CDC. Over the next five years, he sold thousands of dollars’ worth of test kits to his own workplace through the broker. After leaving the CDC in 2017, Zhao spearheaded lucrative contracts with Shanghai officials.
Zhao did not respond to AP requests for comment.
Another of the three companies, GeneoDx, enjoyed special access because it is a subsidiary of the state-owned SinoPharm, which is managed directly by China’s cabinet. In October 2019, GeneoDx co-hosted a CDC internal training conference on emerging respiratory diseases in Shanghai. Tan Wenjie, the CDC official who led the training, then took it upon himself to develop test kits.
GeneoDx did not respond to requests for comment or interviews. The National Health Commission did not respond to a request for comment or an interview with Tan.
The latest company, Huirui, is a longtime partner of Tan, the CDC official in charge of testing kits. In an interview, CEO Li Hui said the CDC routinely contracted with his company to make emergency test chemicals. He denied any personal relationship with Tan or any payment to the CDC.
“We’ve been working with the CDC to respond to new emerging diseases for about ten years, not just a day or two, it’s normal,” Li said.
It is unclear whether the agreements between China’s CDC and the three test kit companies violated Chinese law.
They raise questions about possible violations of bribery laws, along with rules against abuse of authority, self-treatment and conflicts of interest, said James Zimmerman, a Beijing-based corporate attorney and former president of the American Chamber of Commerce. in China.
But other experts warn that the state may have designated the three companies to make test kits under special laws on the procurement of emergency goods during natural disasters.
“Things will be different in the middle of a crisis,” said Lesli Ligorner, a Beijing-based lawyer specializing in anti-corruption law. “I would not rush to judge.”
The first step in making test kits is to obtain samples of the virus and decode its genetic sequence. This leads to test designs, essentially a recipe for tests.
In previous outbreaks, China’s CDC sent test designs and test compounds to laboratories across the country within days of identifying the pathogen. But this time, they retained the genome and the test designs. Instead, they finalized “technology transfer” agreements to deliver the test designs to the Shanghai companies, according to three people familiar with the matter. The selection process was kept secret.
At the same time, central CDC authorities prevented others from testing. Provincial CDC staff were told that instead of testing and reporting cases themselves, they had to send patient samples to designated laboratories in Beijing for full sequencing, a complicated and time-consuming procedure. As a result, for weeks, local CDC staff were unable to confirm new cases.
After an internal teleconference on January 14 to order secret preparations for a pandemic, China’s health authorities relaxed the requirements to confirm cases and began distributing CDC-approved test kits. A day after the first test kits finally arrived in Wuhan on January 16, the case count began to rise again.
But the GeneoDx and Huirui test kits had quality issues and returned inconclusive or false negative results. And technicians were hesitant to use test kits that would later turn out to be more accurate from more established companies, because the CDC did not endorse them.
As a result, in the early days, getting a Covid test was so difficult that Wuhan residents compared it to winning the lottery.
Among the victims was Peng Yi, a 39-year-old school teacher who started coughing on January 23. When he went to the hospital, he waited eight hours, only to be turned away for lack of test kits. Then when he was finally tested on January 30, it came back negative, even as the virus ravaged his lungs.
His second test, on February 4, came back positive. It was too late. Weeks later, Peng passed away.
“There was very, very little testing, basically none … if you couldn’t prove positive, you couldn’t go into hospital,” his mother, Zhong Hanneng, said in an emotional interview in October. “The doctor said nothing could be done.”
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