In previous administrations, a letter to an international organization signed by the U.S. president generally would have been carefully vetted and fact-checked. But President Trump’s May 18 letter to World Health Organization Director General Tedros Adhanom Ghebreyesus contains a number of false or misleading statements. Here’s a sampling, as well as a guide to some of his claims:

“The World Health Organization consistently ignored credible reports of the virus spreading in Wuhan in early December 2019 or even earlier, including reports from the Lancet medical journal. The World Health Organization failed to independently investigate credible reports that conflicted directly with the Chinese government’s official accounts, even those that came from sources within Wuhan itself.”

Richard Horton, the Lancet’s editor in chief, said no such study existed. “Dear President Trump — You cite The Lancet in your attack on WHO,” Horton tweeted. “Please let me correct the record. The Lancet did not publish any report in early December, 2019, about a virus spreading in Wuhan. The first reports we published were from Chinese scientists on Jan 24, 2020.”

In a fuller statement, the Lancet said Trump’s reference to the alleged study was “factually incorrect,” as no report was published in December 2019 “referring to a virus or outbreak in Wuhan or anywhere else in China.”

The sentence in Trump’s letter could have been imprecisely phrased. The Jan. 24 Lancet study says “the symptom onset date of the first patient identified was Dec. 1, 2019,” with patients in the study hospitalized between Dec. 16 and Jan. 2. The White House did not respond to a request for an explanation.

“By no later than December 30, 2019, the World Health Organization office in Beijing knew that there was a ‘major public health’ concern in Wuhan. Between December 26 and December 30, China’s media highlighted evidence of a new virus emerging from Wuhan, based on patient data sent to multiple Chinese genomics companies. Additionally, during this period, Dr. Zhang Jixian, a doctor from Hubei Provincial Hospital of Integrated Chinese and Western Medicine, told China’s health authorities that a new coronavirus was causing a novel disease that was, at the time, afflicting approximately 180 patients.”

Doctors in Wuhan suspected person-to-person transmission of the new disease in mid- to late December, and one company even completed genomic sequencing of the novel coronavirus on Dec. 26, according to a Chinese media report. But the letter uses sleight of hand to suggest Zhang knew at the time that 180 patients were sick. “On December 27, Zhang Jixian, a doctor from Hubei Provincial Hospital of Integrated Chinese and Western Medicine, told China’s health authorities that the disease was caused by a new coronavirus,” reported the South China Morning Post. “By that date, more than 180 people had been infected, though doctors might not have been aware of all of them at the time.”

“By the next day, Taiwanese authorities had communicated information to the World Health Organization indicating human-to-human transmission of a new virus. Yet the World Health Organization chose not to share any of this critical information with the rest of the world, probably for political reasons.”

This is in dispute. On Dec. 31, 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 seven cases 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.

“The International Health Regulations require countries to report the risk of a health emergency within 24 hours. But China did not inform the World Health Organization of Wuhan’s several cases of pneumonia, of unknown origin, until December 31, 2019, even though it likely had knowledge of these cases days or weeks earlier.”

“Human influenza caused by a new subtype” is always supposed to be reported to the WHO within 24 hours. Trump has a point here, but he does not acknowledge that action from the WHO forced China’s hand.

“WHO headquarters in Geneva first learned about the outbreak in Wuhan not directly from Chinese authorities, but rather from the Program for Monitoring Emerging Diseases (ProMED), a U.S.-based open-source platform for early intelligence about infectious disease outbreaks,” according to a comprehensive timeline issued by the Congressional Research Service. Headquarters then “asked the WHO China Country Office to request ‘verification of the event’ from the government of China.” WHO acted under regulations that it “take into account reports from sources other than notifications or consultations” by countries. CRS noted “it appears China may not have proactively notified WHO of the outbreak.”

There is strong evidence Chinese officials were slow to act in response to reports from medical professionals starting in mid-December about a strange new disease. “A bureaucratic culture that prioritizes political stability over all else probably allowed the virus to spread farther and faster,” The Washington Post reported on Feb. 1.

“On January 14, 2020, the World Health Organization gratuitously reaffirmed China’s now-debunked claim that the coronavirus could not be transmitted between humans, stating: ‘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.’ This assertion was in direct conflict with censored reports from Wuhan.”

Trump here cites a tweet by the WHO. But in a news briefing that same day, Maria Van Kerkhove, acting head of the WHO’s emerging diseases unit, told reporters: “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. 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, Middle East respiratory syndrome (MERS) and other respiratory pathogens. 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.”

“On January 21, 2020, President Xi Jinping of China reportedly pressured you not to declare the coronavirus outbreak an emergency. You gave in to this pressure the next day and told the world that the coronavirus did not pose a Public Health Emergency of International Concern. Just over one week later, on January 30, 2020, overwhelming evidence to the contrary forced you to reverse course.”

Note the use of the word “reportedly.” Trump appears to be citing a German news report that was based on a German intelligence finding. The WHO has denied the report as “unfounded and untrue,” noting: “Dr. Tedros and President Xi did not speak on 21 January and they have never spoken by telephone.”

“On January 28, 2020, after meeting with President Xi in Beijing, you praised the Chinese government for its ‘transparency’ with respect to the coronavirus, announcing that China had set a ‘new standard for outbreak control’ and ‘bought the world time.’ You did not mention that China had, by then, silenced or punished several doctors for speaking out about the virus and restricted Chinese institutions from publishing information about it.”

Tedros certainly lavished praise on China at the time, even as evidence mounted that Chinese officials had silenced whistleblowers and undercounted cases. But the same could be said about Trump in this period, who repeatedly praised China’s “transparency” and handling of the outbreak. Here are some examples:

  • Jan. 24, Twitter: “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”
  • Jan. 30, Fox News interview: “China is not in great shape right now, unfortunately. But they’re working very hard. We’ll see what happens. But we’re working very closely with China and other countries.”
  • Jan. 30, remarks at a campaign rally: “Maybe we’ve never had a better relationship [with China], and we’re working with them very closely on the coronavirus. We’re working with them very, very closely. We only have five people [infected]. Hopefully everything’s going to be great. They have somewhat of a problem, but hopefully it’s all going to be great.”
  • Feb. 7, remarks in Charlotte: “I just spoke to President Xi last night, and, you know, we’re working on the — the problem, the virus. It’s a — it’s a very tough situation. But I think he’s going to handle it. I think he’s handled it really well. We’re helping wherever we can.”
  • Feb. 7, Twitter: “Just had a long and very good conversation by phone with President Xi of China. He is strong, sharp and powerfully focused on leading the counterattack on the Coronavirus. He feels they are doing very well, even building hospitals in a matter of only days … Great discipline is taking place in China, as President Xi strongly leads what will be a very successful operation. We are working closely with China to help!”
  • Feb. 7, remarks to reporters: “Late last night, I had a very good talk with President Xi, and we talked about — mostly about the coronavirus. They’re working really hard, and I think they are doing a very professional job. They’re in touch with World — the World — World Organization. CDC also. We’re working together. But World Health is working with them. CDC is working with them. I had a great conversation last night with President Xi. It’s a tough situation. I think they’re doing a very good job.”
President Trump has both praised China’s response to the coronavirus outbreak and criticized China for not being forthcoming enough about the virus. (The Washington Post)

“You also strongly praised China’s strict domestic travel restrictions, but were inexplicably against my closing of the United States border, or the ban, with respect to people coming from China. I put the ban in place regardless of your wishes. Your political gamesmanship on this issue was deadly, as other governments, relying on your comments, delayed imposing life-saving restrictions on travel to and from China.”

Trump’s so-called ban did not block all travel from China but only non-U.S. citizens, with 11 exemptions. The New York Times calculated that nearly 40,000 people traveled from China to the United States two months after Trump imposed restrictions. Moreover, screening proceedings of travelers from China were uneven and inconsistent, the Times said.

The WHO has cautioned against such travel restrictions, saying they are ineffective against a virus and in the long run counterproductive. Trump, according to news reports, was initially skeptical and worried about provoking China after signing a major trade deal. But his national security and public health experts convinced him that the move would buy time to put in place effective prevention and testing measures. (Then the administration failed to ramp up testing for weeks.)

As for Trump’s claim that the WHO’s skepticism about travel restriction preventing other countries from taking action, we have previously calculated that 38 countries imposed similar or tougher restrictions on travel from China before or at the same time the U.S. restrictions were put in place.

“On March 3, 2020, the World Health Organization cited official Chinese data to downplay the very serious risk of asymptomatic spread, telling the world that ‘COVID-19 does not transmit as efficiently as influenza’ and that unlike influenza this disease was not primarily driven by ‘people who are infected but not yet sick.’ China’s evidence, the World Health Organization told the world, ‘showed that only one percent of reported cases do not have symptoms, and most of those cases develop symptoms within two days.’”

Tedros did say this at a March 3 briefing, as part of a presentation on the ways covid-19 was different from the seasonal flu. But he also said “covid-19 causes more severe disease than seasonal influenza. … Globally, about 3.4 percent of reported covid-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1 percent of those infected.” He urged governments to expand contact tracing because it will slow the spread of infections. “We can’t treat covid-19 exactly the same way we treat flu,” Tedros said, noting there would be no vaccine for some time.

His remarks might have been directed at Trump. In late February and early March, Trump was still minimizing the threat posed by the coronavirus. “This is a flu. This is like a flu,” Trump said on Feb. 26. The day before Tedros’s news conference, Trump even speculated at a meeting with pharmaceutical executives that a flu vaccine would work well against the coronavirus.

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The Washington Post Fact Checker is working with the CoronaVirusFacts/DatosCoronaVirus Alliance, a coalition of more than 100 fact-checkers who are fighting misinformation related to the COVID-19 pandemic. Learn more about the alliance here.