Dear Editor,
We write with concern regarding the arbitrary detention of journalists and clinicians who bore witness to the first months of the COVID-19 epidemic in Wuhan, China. In particular, we wish to draw attention to the plight of 39-year-old lawyer Zhang Zhan (张展), who was detained on 15 May 2020, and who has remained in prison for almost 3 years (1).
Ms. Zhang was one of several citizen journalists who attempted to report on the outbreak in Wuhan, among them videographer Li Zehua (李泽华), lawyer Chen Qiushi (陈秋实) and local resident Fang Bin (方斌), all of whom were subsequently held in custody (2, 3). While Li Zehua and Chen Qiushi appear to have been released after lengthy detentions, Fang Bin was last known to be held in a detention facility in Wuhan (4). Zhang Zhan remains in prison after being charged with “picking quarrels and provoking trouble”, for which she was sentenced to a four-year jail term (5).
Ms. Zhang, who was 36 at the time of her arrest, had come to Wuhan from Shanghai on 1 February 2020, hoping to obtain information on the outbreak of the disease that would come to be known as COVID-19 (6). The video footage Ms. Zhang filmed showed the rising extent of morbidity and mortality in Wuhan at a time when government officials were attempting to impose a regime of censorship on the unfolding epidemic (7). For much of her imprisonment, Zhang Zhan has been in poor health, with family members claiming she had been tortured and force-fed via a nasal-gastric tube after going on hunger strike (8).
The detention of citizen journalists and others who attempted to communicate information on the emergence of COVID-19 occurred as central Chinese authorities sought to suppress both public and private discussion of the new disease (9). Several clinicians working in Wuhan, among them the ophthalmologist Dr. Li Wenliang (李文亮), were detained and reprimanded after discussing the outbreak on a private messaging app (10). Dr. Ai Fen (艾芬), head of the Emergency Department of Wuhan Central Hospital, was reprimanded for seeking to confirm pathology results that indicated patients were infected with an as-yet unidentified coronavirus (11). Dr Li Wenliang later died after being infected with the new virus while attending to an asymptomatic patient (12). His Weibo profile has since become a digital site of pilgrimage for millions of Chinese seeking to memorialise the pandemic (13).
The persecution of clinicians and journalists who attempted to communicate information in the first months of the COVID-19 epidemic in Wuhan recalls the similar plight of those who sought transparency on the outbreak of Severe Acute Respiratory Syndrome (SARS) 17 years earlier. This year, 2023, saw the passing of Jiang Yanyong (蒋彦永), a military doctor and career officer of the People’s Liberation Army who exposed the extent of the SARS outbreak amid widespread government censorship (14). In April 2003, Jiang alerted international media to the fact that hundreds of SARS cases were being concealed by central authorities (15). In subsequent years, Jiang was subjected to periods of arbitrary detention, house arrest and “re-education” (16). In early 2020, as COVID-19 emerged, Jiang was again detained and held under house arrest, where he was prevented from speaking to any independent media until his death at the age of 91 (16).
Officials from the World Health Organization first learned of an outbreak of “viral pneumonia of unknown cause” in Wuhan on December 31st, 2019, via Pro-MED mail, a publication of the International Society for Infectious Diseases (17, 18, 19). The previous day, the Wuhan Municipal Health Commission had issued an order prohibiting all public communication in relation to the outbreak, which was subsequently leaked online (20). Journalists at the news outlet Sina Finance then asked local officials to confirm the authenticity of the leaked document, resulting in media reports (21, 22) that were translated and further disseminated by Pro-MED (17). It was these channels, rather than any official communication from central authorities in Beijing, that first alerted international health authorities to the outbreak (19, 23).
In 2005, two years after the SARS epidemic began, the WHO revised its International Health Regulations (IHR). The updated IHR created a legally binding framework under which member states of the WHO must report detection of potential public health emergencies of international concern within 24 hours (24). As described above, independent news reporters and non-government disease surveillance played a critical role in alerting the international community to the advent of COVID-19. This is a reminder of the value of freedom of expression, both as an ethical concern and a practical tool for promoting global health security. Rather than being prosecuted, those who sought a clearer picture of the early months of the Wuhan epidemic should be properly commended.
1. Amnesty International. Free Zhang Zhan [ongoing petition]. https://www.amnesty.org/en/petition/china-zhang-zhan/
2. Wang V. They documented the coronavirus crisis in Wuhan – then they vanished. The New York Times. 2020 Feb 14. https://www.nytimes.com/2020/02/14/business/wuhan-coronavirus-journalists.html
3. Kuo L. The journalist who wouldn’t stay quiet on Covid-19. The Guardian. 2020 Mar 1. https://www.theguardian.com/world/2020/mar/01/li-zehuajournalist-wouldnt-stay-quiet-covid-19-coronavirus
4. Radio Free Asia. 方斌被指关押在武汉看守所 官方拒绝证实. (‘Fang Bin thought to be held in Wuhan Detention Centre, officials refuse to confirm’). 2022 Feb 9. https://www.rfa.org/mandarin/yataibaodao/renquanfazhi/wy-02082022121047.html
5. United Nations Human Rights Commission. Journalist jailed for COVID reporting seriously ill, must be released [press release]. 2021 Nov 22. https://www.ohchr.org/en/press-releases/2021/11/china.-journalist-jailed-covid-reporting-seriously-ill-must-be-released-un
6. Rui G. Chinese citizen journalist detained after live-streaming on coronavirus in Wuhan. South China Morning Post. 2020 May 18. https://www.scmp.com/news/china/politics/article/3084882/chinese-citizen-journalist-detained-after-live-streaming
7. Rudolph J. 17 years after SARS crisis, Beijing controls coronavirus information. China Digital Times. 2020 Jan 23. https://chinadigitaltimes.net/2020/01/17-years-after-sars-crisis-beijing-controls-coronavirus-information/
8. Human Rights Watch. China: Release gravely ill activist. 2021 Nov 4. https://www.hrw.org/news/2021/11/04/china-release-gravely-ill-activist
9. Yuan L. China silences critics over deadly virus outbreak. The New York Times. 2020 Jan 25. https://www.nytimes.com/2020/01/22/health/virus-corona.html
10. Lew L. Coronavirus: Mother of whistle-blower Li Wenliang demands answers for his treatment by Wuhan police. South China Morning Post. 2020 Feb 9. https://www.scmp.com/news/china/society/article/3049706/coronavirus-mother-whistle-blower-li-wenliang-demands-answers
11. Kuo L. Coronavirus: Wuhan doctor speaks out against authorities. The Guardian. 2020 Mar 11. https://www.theguardian.com/world/2020/mar/11/coronavirus-wuhan-doctor-ai-fen-speaks-out-against-authorities
12. Zhou C. Coronavirus: Whistle-blower Dr. Li Wenliang confirmed dead. South China Morning Post. 2020 Feb 7. https://www.scmp.com/news/china/society/article/3049411/coronavirus-li-wenliang-doctor-who-alerted-authorities-outbreak
13. Carter C. Li Wenliang’s wailing wall. China Digital Times. 2023 Jan 6. https://chinadigitaltimes.net/2023/01/li-wenliangs-wailing-wall-november-december-2022-zero-covid-is-over-but-im-afraid-to-go-out/
14. Associated Press. Chinese SARS whistle-blower Jiang Yanyong dies at 91. 2023 Mar 14. https://apnews.com/article/sars-whistleblower-jiang-dead-china-covid-19c278389af0fd2531ba320b051e5c29
15. Boyd A. Censorship follows death of Jiang Yanyong, SARS whistle-blower and critic of Tiananmen Massacre. China Digital Times. 2023 Mar 22. https://chinadigitaltimes.net/2023/03/jiang-yanyong-sars-whistleblower-and-critic-of-tiananmen-massacre-dies-in-beijing/
16. Yu V. Doctor who exposed China’s cover-up of SARS crisis dies aged 91. The Guardian. 2023 Mar 15. https://www.theguardian.com/world/2023/mar/14/doctor-who-exposed-chinas-cover-up-of-sars-crisis-dies-aged-91
17. International Society for Infectious Diseases. Undiagnosed pneumonia – China (HU): RFI. Archive Number: 20191230.6864153. 2019 Dec 31. https://promedmail.org/promed-post/?id=20191230.6864153
18. World Health Organization. Listings of WHO’s response to COVID-19 [online statement]. 2020 Jun 29. https://www.who.int/news/item/29-06-2020-covidtimeline#cms
19. Sachs JD, Karim SSA, Aknin L, et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet. 2022;400(10359):1224-1280. doi:10.1016/S0140-6736(22)01585-9
20. Wuhan Municipal Health Commission. 关于做好不明原因肺炎救治工作的紧急通知. (‘Urgent notice on doing a good job in the treatment of pneumonia of unknown cause’.) Issued Dec 30, 2019. [Accessed via Wikimedia Commons, Apr 13, 2023.] https://zh.wikipedia.org/zh-hans/File:%E5%85%B3%E4%BA%8E%E5%81%9A%E5%A5%BD%E4%B8%8D%E6%98%8E%E5%8E%9F%E5%9B%A0%E8%82%BA%E7%82%8E%E6%95%91%E6%B2%BB%E5%B7%A5%E4%BD%9C%E7%9A%84%E7%B4%A7%E6%80%A5%E9%80%9A%E7%9F%A5.pdf
21. Sina Finance. 武汉不明原因肺炎已隔离 检测结果将第一时间公布. (‘Pneumonia of unknown cause has been quarantined and the test results will be announced as soon as possible’). 2019 Dec 31. https://finance.sina.cn/2019-12-31/detail-iihnzahk1074832.d.html?from=wap [Accessed Apr 13, 2023.]
22. Sina Finance Mobile. 武汉不明原因肺炎患者和发病地点已隔离 多医院召开专题会防控救治.(‘Patients with pneumonia of unknown cause in Wuhan and the place of onset have been isolated; hospitals hold special meetings on prevention and treatment.’) 2019 Dec 31. https://tech.sina.com.cn/roll/2019-12-31/doc-iihnzhfz9428799.shtml [Accessed Apr 13, 2023.]
23. Independent Panel for Pandemic Preparedness and Response. COVID-19: Make it the last pandemic: Final report. 2021 May 12. https://theindependentpanel.org/wp-content/uploads/2021/05/COVID-19-Make-it-the-Last-Pandemic_final.pdf
24. World Health Organization. Annex 2 of the International Health Regulations (2005). 2017 Nov 30. https://www.who.int/publications/m/item/annex-2-of-the-international-health-regulations-(2005)