— President Trump, remarks at a news conference, April 14, 2020
This fact check has been updated with responses from the White House
The president’s announcement that he would suspend payments to the World Health Organization in the midst of the coronavirus pandemic contained a number of false or misleading claims. He faulted the WHO for believing that China was doing a good job and praising its transparency — when he had done the same thing at the time. He claimed the WHO “fought” his decision to impose some restrictions on travel from China, but WHO officials said nothing publicly; opposition to travel restrictions has been a consistent WHO policy.
That’s the usual Trump hyperbole and flip-flopping. For the purposes of this fact check, we will examine the part of Trump’s statement that holds some credibility — that the WHO did not alert the world quickly that the new virus could travel among people. We have assembled a detailed timeline to look at what the organization said.
The WHO is a United Nations organization, with all of its inherent bureaucracy, slow decision-making and dependence on member states. The WHO is heavily reliant on information provided by countries and cannot fine countries that fail to provide accurate information. But that does not mean officials cannot use its platform to express skepticism or prod for more transparency, rather than amplify incomplete information.
Dec. 31, 2019: The WHO was alerted to a potentially new virus in China.
That same day, the Taiwan Centers for Disease Control said it sent an email to the WHO regarding rumors of at least “seven cases of atypical pneumonia,” which it said is code in China for “a disease transmitted between humans caused by coronavirus.”
Taiwan is not a member of the WHO, and the WHO says the email never mentioned human-to-human transmission. “Public health professionals could discern from this wording that there was a real possibility of human-to-human transmission of the disease,” the Taiwan CDC argues. “However, because at the time there were as yet no cases of the disease in Taiwan, we could not state directly and conclusively that there had been human-to-human transmission.”
Apparently, Taiwanese officials had been alerted to Dec. 30 posts in a chat room by a doctor, Li Wenliang, in which he said that seven cases he had been treating resembled severe acute respiratory syndrome, or SARS, a deadly form of coronavirus. Li was reprimanded by the Chinese government for illegally spreading rumors. He later died of covid-19, the disease caused by the novel coronavirus.
Analysis: Trump had said “there was credible information to suspect human-to-human transmission in December 2019, which should have spurred the WHO to investigate, and investigate immediately.” The White House said this was a reference to the information circulating in China that prompted the Taiwanese CDC email.
“Taiwan authorities contacted the WHO about medical staff in Wuhan who were getting ill with a new type of pneumonia, signaling human-to-human transmission,” a senior administration official said. “This key information was seemingly disregarded by the WHO, which does not allow Taiwan to participate in its meetings due to Chinese political pressure, and not shared with the world until later in January.”
But at best, we’re talking about the last two days in December.
Jan. 5 WHO news release: “On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China. … Based on the preliminary information from the Chinese investigation team, no evidence of significant human-to-human transmission and no health care worker infections have been reported.”
Jan. 9 WHO statement: “Chinese authorities have made a preliminary determination of a novel (or new) coronavirus, identified in a hospitalized person with pneumonia in Wuhan. … Coronaviruses are a large family of viruses with some causing less-severe disease, such as the common cold, and others more severe disease such as MERS and SARS. Some transmit easily from person to person, while others do not. According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people. … More comprehensive information is required to understand the current status and epidemiology of the outbreak, and the clinical picture.”
Jan. 10 WHO health-worker guidance released: “Based on experience with SARS and MERS and known modes of transmission of respiratory viruses, infection and prevention control guidance were published to protect health workers recommending droplet and contact precautions when caring for patients, and airborne precautions for aerosol generating procedures conducted by health workers.”
Jan. 12 WHO news release: “The evidence is highly suggestive that the outbreak is associated with exposures in one seafood market in Wuhan. The market was closed on 1 January 2020. At this stage, there is no infection among healthcare workers, and no clear evidence of human to human transmission.”
Analysis: The WHO uses terms such as “no clear evidence,” but it also associates the new virus with SARS and Middle East respiratory syndrome (MERS) and urges protection for health workers. It notes that some coronaviruses can “transmit easily from person to person.” But the WHO is mainly echoing information provided by China — where there already was growing evidence of human-to-human transmission, though the Chinese government did not admit that yet.
Jan. 13: Thailand announces it has the first imported case of the coronavirus. The individual, who lived in Wuhan, had arrived from China on Jan. 8.
Jan. 13 WHO news release: “The way these patients became infected is not yet known. To date, there has been no suggestion of human to human transmission of this new coronavirus. There have been no infections reported among health care workers, which can be an early indicator of person to person spread.”
Jan. 14 WHO news release: “Based on the available information there is no clear evidence of human-to-human transmission. No additional cases have been detected since 3 January 2020 in China.”
Jan. 14 WHO tweet: “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China.”
Jan. 14 WHO news briefing: “From the information that we have 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,” said Maria Van Kerkhove, acting head of the WHO’s emerging diseases unit. “It is still early days, we don’t have a clear clinical picture.”
Van Kerkhove added, however, that human-to-human transmission would not be surprising given the WHO’s experience with SARS, MERS and other respiratory pathogens.
“What we have seen from both SARS and from MERS is we have had limited human-to-human transmission, and that there are amplification events,” Van Kerkhove told reporters. “There is the possibility that transmission can be amplified. Most notably in health-care facilities.”
Analysis: The Jan. 14 tweet has gotten the most attention, and both the tweet and the news release continue with the “no clear evidence” language. But the news briefing was much starker and reflected the urgency posed by the case in Thailand.
Van Kerkhove’s message was not lost on reporters. The Telegraph in Britain headlined its article on the news conference: “WHO refuses to rule out human-to-human spread in China’s mystery coronavirus outbreak.”
The Telegraph noted that it was a surprise that the virus had ended up in Thailand because authorities had been tracking 763 people who may have come into contact with the virus, including 419 health workers. Jimmy Whitworth, professor of international public health at the London School of Hygiene and Tropical Medicine, told the newspaper: “This sounds like somebody who has slipped through the net. If one person has, have others?” He prophetically added: “With Chinese new year and millions of people traveling, even with limited transmission there’s some chance that this could transmit further.”
Jan. 19 WHO tweet: “An animal source seems the most likely primary source of this novel #coronavirus (2019-nCoV) outbreak, with some limited human-to-human transmission occurring between close contacts.”
Jan. 20 WHO tweet: “It is now very clear from the latest information that there is at least some human-to-human transmission of #nCoV2019. Infections among health care workers strengthen the evidence for this.” At the time, there were only 222 confirmed cases in the world, including four deaths.
Jan. 21: First case identified in the United States.
Jan. 22 WHO news release: “Data collected through detailed epidemiological investigation and through the deployment of the new test kit nationally suggests that human-to-human transmission is taking place in Wuhan. More analysis of the epidemiological data is needed to understand the full extent of human-to-human transmission.”
In an interview with CNBC that same day, Trump said: “We have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.”
Analysis: Five days after the Jan. 14 tweet and news conference, the WHO made it clear that human-to-human transmission was possible. On Jan. 20, China had admitted this, too.
“The World Health Organization’s word carries much more weight than those of the Communist Party of China. The world relies on the WHO to be an honest broker,” the senior administration official said. He added: “The President has offered positive comments and words of support for President Xi and the Chinese people throughout this global crisis. The world counted on the WHO to assess the rapidly developing outbreak in China in order to contain it at its source. Their inability to do so led to an incalculable loss of human life and immeasurable economic damage. The WHO must be held accountable.”
The Pinocchio Test
Trump could have made a case that the WHO was slow to speak firmly about the possible human-to-human transmission. But he puts the onus on the WHO to investigate when it is largely dependent on information provided by member countries. (Leave aside the fact that Trump kept praising China’s transparency. If he had been more publicly critical, it might have forced China to respond more appropriately.)
But Trump really gets over his skis when he claims that the WHO “publicly endorsed the idea that there was not human-to-human transmission happening” and that the WHO said it was “not communicable.” The WHO said initially that there was “no clear evidence.” But by Jan. 14, a senior official said they could not rule out human-to-human transmission given the experience with SARS. That statement was made only two weeks after the WHO first learned of the new virus.
It’s almost a Four-Pinocchio claim but not quite. The WHO could have highlighted the human-to-human transmission sooner than it did and pressed China for more information. Trump, of course, could have done the same — and failed to do so, for weeks longer. Trump earns Three Pinocchios.
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