Will the China report on 266 patients Nov. 17-Dec. 31, 2019 be made public by China, WHO, or by WHA resolution next week?

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By Daniel R. Lucey MD, MPH, FIDSA

In a recent Science paper by Pekar, Worobey and colleagues titled “Timing the SARS-CoV-2 index case in Hubei province” the authors conclude “Our results define the period between mid-October and mid-November 2019 as the plausible interval when the first case of SARS-CoV-2 emerged in Hubei province.

Referencing reporting by the senior journalist and China news editor, Josephine Ma, at the South China Morning Post one year earlier, on March 13, 2020, Pekar et al. state “newspaper reports document retrospective CVOID-19 diagnoses recorded by the Chinese government going back to 17 November 2019 in Hubei province. In fact, these reports detail daily retrospective COVID-19 diagnoses through the end of November, suggesting that SARS-CoV-2 was actively circulating for at least a month before it was discovered.”

In her March 2020 South China Morning Post reporting, titled “Coronavirus: China’s first confirmed Covid-19 case traced back to November 17,” Ma wrote:

The first case of someone in China suffering from Covid-19, the disease caused by the novel coronavirus, can be traced back to November 17, according to government data seen by the South China Morning Post.

Chinese authorities have so far identified at least 266 people who were infected last year, all of whom came under medical surveillance at some point.

Some of the cases were likely backdated after health authorities had tested specimens taken from suspected patients.

Ma also wrote:

Of the first nine cases to be reported in November – four men and five women – none has been confirmed as being “patient zero”. They were all aged between 39 and 79, but it is unknown how many were residents of Wuhan, the capital of Hubei and the epicentre of the outbreak.”

The direct relevance of this information was made explicit by Ma:

“While the government records have not been released to the public, they provide valuable clues about how the disease spread in its early days and the speed of its transmission, as well as how many confirmed cases Beijing has recorded.

In this IDSA/HIVMA Science Speaks space June 30, 2020, and in a New York Times interview published online July 8, 2020, I included this reporting by Josephine Ma as one of the 8 questions for the WHO-China Joint Team studying the origins of SARS-CoV-2 following a World Health Assembly resolution May 2020. The March 30, 2021 final report of this WHO-China Joint Team, however, did not even mention the important information reported by Ma in the South China Morning Post March 13, 2020.

Perhaps it was only a numerical (N = 266) coincidence that the WHO-China Joint Report stated that the China team evaluated a total of 266 suspected and confirmed cases including 174 patients with COVID-19 between December 8-31 and another 92 patients between October 1 and December 10, 2019 “considered to have an illness compatible with SARS-CoV-2 infection” (see p. 49).  Although the China team rejected all 92 of these patients as having COVID-19, their sum total of 266  (174 + 92) patients evaluated for COVID-19 as of Dec. 31, 2019 is the same number (266) evaluated and found to have COVID-19 between Nov. 17 and Dec. 31, 2019 in the Chinese government report referred to in the reporting by Josephine Ma in the SCMP March 13, 2020.

Also, at the upcoming May 24-June 1, annual World Health Assembly the “Independent Panel for Pandemic Preparedness and Response” will present its findings, including what is described as “COVID-19: The Authoritative Chronology, December 2019-March 2020.”  Surprisingly, although many media references are included in this chronology, the essential reporting by Josephine Ma in the South China Morning Post March 13, 2020 citing the initial nine cases (five women, four men, ages 39-79) in Hubei province starting Nov.17 is not included.

It is past time for full public transparency about the details of this government report seen by Ma and the South China Morning Post in 2020 in order to better understand the initial outbreak timing and epidemiology. Perhaps China, or WHO will do so at the World Health Assembly next week. If not, then it is to be hoped that whatever new WHA resolution(s) regarding the search for the origins of SARS-CoV-2 and the COVID-19 pandemic are made, they will include full disclosure and public transparency of this China government report that described 266 patients in Hubei province between Nov.17-Dec. 31, 2019.


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Dr. Daniel Lucey

Daniel Lucey, M.D. MPH, FIDSA, FACP, is a Clinical Professor of Medicine at Dartmouth Geisel School of Medicine, Infectious Disease adjunct Professor at Georgetown Medical Center, senior scholar at Georgetown Law, Anthropology Research Associate at the Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee. He served as a volunteer to outbreaks overseas including hands-on Ebola patient care in Sierra Leone and Liberia (Doctors without Borders) 2014, MERS 2013, SARS 2003, as well as HIV, H5N1, Zika, yellow Fever, and pneumonic plague 2017 (with WHO/USAID/CDC).  Since Jan. 6, 2020 he has contributed more than 100 posts to Science Speaks on COVID-19 and traveled to China in February 2020. He initially proposed, then fundraised and helped design the content for 2018-2022 Smithsonian Exhibition on Epidemics due to zoonotic viruses. From 1982-1988 he trained at University of California San Francisco and Harvard and was an attending physician at the NIH (NIAID) in the 1990s while in the U.S. Public Health Service.

One thought on “Will the China report on 266 patients Nov. 17-Dec. 31, 2019 be made public by China, WHO, or by WHA resolution next week?

  1. GillesDemaneuf

    Hi Daniel,

    Another important point to keep in mind is that there were 361 ‘confirmed’ cases as of the 1st January 20according to the CDC data seen by Josephine Ma, as mentioned in her article.
    So that means a jump from 266 to 361 in one day.

    Now we know that the much of the reported cases were delayed somehow to the 1st January.
    I described that in details in my Silent Numbers (https://bit.ly/2OyytJ4). See for instance the CDC graphs with that odd jump on the 1st Jan.

    What it means practically is that there were closer to 330 ‘confirmed’ cases in 2019, if you reallocate that spurious jump to 361 back to 2019.

    Also note the age of the nine November cases: 39 to 79. Quite old. So practically many more asymptomatic or mild cases going around in November 2019.
    Peter Embarek reckoned that 1,000 2019 cases is possible in an interview. With 330 confirmed cases, I would say that 6×330 = 1,980, so nearly 2,000 cases in 2019 is well possible.

    Last, please check the November cases mentioned in Health Times, and withdrawn just as the CDC gag order was issued (SCMP_Mar20 tab in the Silent Numbers spreadsheet).



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