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President Donald Trump laid out specific accusations against the World Health Organization as he announced that the United States would halt its financial support during the COVID-19 pandemic.
"The world depends on the WHO to work with countries to ensure that accurate information about international health threats is shared in a timely manner, and if it’s not, to independently tell the world the truth about what is happening," Trump said.
We scrutinized the evidence behind three specific claims from Trump’s remarks.
"They told us, when we put on our travel ban — a very strong travel ban — there was no need to do it. ‘Don’t do it.’ They actually fought us."
WHO did not recommend travel bans, but Trump magnifies the extent of the disagreement. We found no record of WHO objecting to the American policy specifically.
On Jan. 30, WHO declared that COVID-19 had reached the highest level of alert, a Public Health Emergency Of International Concern. It said "all countries should be prepared for containment" and urged them to launch testing and tracing programs.
In its statement, WHO said it "does not recommend any travel or trade restriction." But it also acknowledged that countries could impose limits, saying, "Countries must inform WHO about travel measures taken, as required by the International Health Regulations."
Those regulations, first drafted in 2005 after China hid the SARS epidemic from the world, spell out what each country and bodies like WHO must do in the face of a new infectious disease. The document says that countries need to explain why a travel ban is warranted.
Trump announced a ban Jan. 31, which took effect Feb. 2.
The United States had company in banning entry from China. Singapore moved on Jan. 29, Italy suspended all flights Jan. 31, and Australia imposed a ban on Feb.1, to mention just a few of the more than 40 nations that acted at about the same time.
As late as Feb. 29, WHO was not recommending travel restrictions. It said that "restricting the movement of people and goods during public health emergencies is ineffective in most situations."
Eric Goosby, professor health at the University of California San Francisco and former U.S. global AIDS coordinator, said the research backs up WHO’s policy. There’s no proof that closing borders works against viruses. Worse, he said, they can be counterproductive.
"There’s a risk with travel bans of domino effects that don’t help fight the outbreak," Goosby said. "And other steps, like testing, do more to help countries respond and contain an infectious disease."
"There was credible information to suspect human-to-human transmission in December 2019, which should have spurred the WHO to investigate, and investigate immediately. ... Through the middle of January, it parroted and publicly endorsed the idea that there was not human-to-human transmission happening despite reports and clear evidence to the contrary."
Health experts say Trump is wrong about early, credible evidence of human-to-human transmission.
"There were questions, but no solid confirmation," Boston University global health researcher Davidson Hamer said. "It wasn’t until mid January that reasonable evidence began to come out."
So, Trump is right when he points to mid January as the pivot point, but he’s off the mark about the quality of the information earlier.
On Jan. 12, WHO said that "there is no clear evidence that the virus passes easily from person to person."
On Jan. 14, WHO’s lead investigator Maria Van Kerkhove told reporters that "it is possible that there is limited human-to-human transmission, potentially among families, but it is very clear right now that we have no sustained human-to-human transmission."
Van Kerkhove however warned that a wider outbreak was possible and that WHO had told hospitals around the world to take steps to prevent spreading the infection.
On Jan. 19, Chinese officials confirmed human-to-human transmission.
We asked the White House and the Trump campaign to explain the basis for the claim about evidence from December. We did not hear back.
The closest match we found were reports about a doctor in Wuhan who warned his colleagues in a chat group about a disease that looked like SARS on Dec. 30. Local officials muzzled the doctor, who later died from COVID-19.
"We now have good evidence that Chinese authorities knew about the spread and were hiding it at this time," said Ashish K. Jha, Director, Harvard Global Health Institute. "Whistleblowers and ‘rumor mongers’ among healthcare professionals were silenced. But it’s unclear how much the WHO could have possibly known about that at the time."
Hamer said that he might have been too trusting of what China was reporting, perhaps because the government was much more transparent than it had been in 2002 with the SARS pandemic.
He was hearing from his global health colleagues at the time that "this was the real deal." Hamer thinks WHO could have been faster.
"They took a little too long to declare this a major emergency," Hamer said. "They waited a week to 10 days to come out and say this thing was moving quickly and was a global health concern."
"Had the WHO done its job to get medical experts into China to objectively assess the situation on the ground and to call out China’s lack of transparency, the outbreak could have been contained at its source, with very little death."
This overstates WHO’s ability to get a team into China, and exaggerates the impact WHO could have had if it arrived sooner.
By Jan. 12, China had shared the genetic sequence of the virus, but it delayed on accepting a mission of infectious disease specialists from WHO.
At the end of January, China agreed to work with a WHO group of doctors and epidemiologists. The group didn’t arrive until mid February. The international regulations give each country full control over such visits.
"WHO has no additional authority they could have exercised," Jha said. "As an organization made up of member states, they can only provide guidance, aid, and coordination, but not force member states to do anything."
According to every expert we spoke to, the presumption that a WHO team would have had a major impact is suspect.
"The rules of engagement were unclear," Georgetown Law School professor Lawrence Gostin said. "Could, for example, WHO have independent access to data, talk with scientists and doctors freely? It was never likely WHO would have significant access to China to work as genuine partners."
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White House, Remarks by President Trump in Press Briefing, April 14, 2020
World Health Organization, Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV), Jan. 30, 2020
World Health Organization, Statement on the meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV), Jan. 23, 2020
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Interview, Eric Goosby, professor of global health, University of California - San Francisco, April 15, 2020
Interview, Davidson Hamer, professor of global health, Boston University, April 16, 202
Email exchange, Ashish K. Jha, director, Harvard Global Health Institute, April 16, 2020
Email exchange, Lawrence Gostin, professor, director, O'Neill Institute for National and Global Health Law, Georgetown School of Law, April 16, 2020