London — A group of frontline medical workers, likely exhausted, stand huddled together on a video-conference call as China's most powerful man raises his hand in greeting. It is February 10 in Beijing and President Xi Jinping, who for weeks has been absent from public view,
is addressing hospital staff in the city of Wuhan as they battle to contain the spread of a still officially unnamed novel coronavirus.
From a secure room about 1,200 kilometers (745 miles) from the epicenter, Xi expressed his condolences to those who have died in the outbreak. He urged greater public communication, as around the world concerns mounted about the potential threat posed by the new disease.
That same day, Chinese authorities reported 2,478 new confirmed cases -- raising the total global number to more than 40,000, with fewer than 400 cases occurring outside of mainland China. Yet CNN can now reveal how official documents circulated internally show that this was only part of the picture.
In a report marked "internal document, please keep confidential," local health authorities in the province of Hubei, where the virus was first detected, list a total of 5,918 newly detected cases on February 10, more than double the official public number of confirmed cases, breaking down the total into a variety of subcategories. This larger figure was never fully revealed at that time, as China's accounting system seemed, in the tumult of the early weeks of the pandemic, to downplay the severity of the outbreak.
The previously undisclosed figure is among a string of revelations contained within 117 pages of leaked documents from the Hubei Provincial Center for Disease Control and Prevention, shared with and verified by CNN.
Taken together, the documents amount to the most significant leak from inside China since the beginning of the pandemic and provide the first clear window into what local authorities knew internally and when.
The Chinese government has steadfastly rejected accusations made by the United States and other Western governments that it deliberately concealed information relating to the virus, maintaining that it has been upfront since the beginning of the outbreak. However, though the documents provide no evidence of a deliberate attempt to obfuscate findings, they do reveal numerous inconsistencies in what authorities believed to be happening and what was revealed to the public.
The documents, which cover an incomplete period between October 2019 and April this year, reveal what appears to be an inflexible health care system constrained by top-down bureaucracy and rigid procedures that were ill-equipped to deal with the emerging crisis. At several critical moments in the early phase of the pandemic, the documents show evidence of clear missteps and point to a pattern of institutional failings.
One of the more striking data points concerns the slowness with which local Covid-19 patients were diagnosed. Even as authorities in Hubei presented their handling of the initial outbreak to the public as efficient and transparent, the documents show that local health officials were reliant on flawed testing and reporting mechanisms. A report in the documents from early March says the average time between the onset of symptoms to confirmed diagnosis was 23.3 days, which experts have told CNN would have significantly hampered steps to both monitor and combat the disease.
China has staunchly defended its handling of the outbreak. At a news conference on June 7, China's State Council released a White Paper saying the Chinese government had always published information related to the epidemic in a "timely, open and transparent fashion."
"While making an all-out effort to contain the virus, China has also acted with a keen sense of responsibility to humanity, its people, posterity, and the international community. It has provided information on Covid-19 in a thoroughly professional and efficient way. It has released authoritative and detailed information as early as possible on a regular basis, thus effectively responding to public concern and building public consensus," says the White Paper.
CNN has reached out to China's Ministry of Foreign Affairs, and National Health Commission, as well as Hubei's Health Commission, which oversees the provincial CDC, for comment on the findings disclosed in the documents, but received no response.
Health experts said the documents laid bare why what China knew in the early months mattered.
"It was clear they did make mistakes -- and not just mistakes that happen when you're dealing with a novel virus -- also bureaucratic and politically-motivated errors in how they handled it," said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, who has written extensively on public health in China. "These had global consequences. You can never guarantee 100% transparency. It's not just about any intentional cover-up, you are also constrained with by technology and other issues with a novel virus. But even if they had been 100% transparent, that would not stop the Trump administration downplaying the seriousness of it. It would probably not have stopped this developing into a pandemic."
