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Photo illustration: Eniola Odetunde/Axios. Photos: Ira L. Black (Corbis), Pool/Getty Images

A lack of transparency by Chinese officials — particularly about the novel coronavirus' transmission and the obstruction of a top U.S. scientist from investigating it — played a significant role in allowing COVID-19 to spread outside China, NIAID director Anthony Fauci tells Axios.

The big picture: Axios first spoke with Fauci one year ago this week about the "mysterious pneumonia" in Wuhan, China, which he suspected was a novel coronavirus but was being reported by Chinese health officials as not that infectious.

  • "Back then, the lack of full appreciation of the seriousness of what we were dealing in, was [due to] a number of reasons," Fauci says. "Some things were absolutely not known by anybody. And, some things were known by the Chinese and they weren't very transparent about it," he adds, citing their delayed reporting on person-to-person and asymptomatic transmission of the virus.
  • Many people outside China "got fooled," he says, because they didn't know the virus causing the pandemic was acting differently from its cousin, SARS-CoV, where people infected with SARS show symptoms.
  • If China had revealed its asymptomatic spread earlier, it would have "changed everything" for guidance around masks, social distancing and contact tracing, he says.

China also refused to allow foreign scientists to investigate the virus on the ground "for a considerable period," limiting the ability to see how it was transmitting and to trace its origin, he says.

  • When they finally did allow an international group led by the WHO, they still blocked some of those scientists, including one from NIAID, from traveling to Wuhan from Beijing.
  • And this week, China delayed travel authorization for a group of WHO-led international scientists planning to investigate the virus origins.

Looking back over the prior year, Fauci and other public health experts say there are some lessons learned...

1) Communication is key.

  • "You don't know everything you need to know the first day," and as data accumulate, public health guidelines will evolve, Fauci says.
  • Some public health experts say that process could have been explained to the public more clearly, particularly as guidance changed.
  • "The key here is not that we didn't know what to do, but there were barriers that prevented that, whether they be political or other," says Tara Kirk Sell, senior scholar at Johns Hopkins Center for Health Security. "The CDC has this guidance called Crisis & Emergency Risk Communication. It's science-based and works well, but we didn't [use] it."

2) Misinformation and disinformation is hugely damaging.

  • These were "incredibly powerful in this pandemic," says Sell, adding they can affect people's health and national security. "We really need a national strategy to combat this."

3) "Political divisiveness is a big hindrance to an adequate public health response," Fauci says.

  • "You get people who are making decisions about their own behavior based on political considerations, as opposed to an objective evaluation of the public health threat," Fauci adds.
  • "Public health has always been political, but it's never really been as partisan as it's been this time around. Partisanship in public health has been really incredibly dangerous in this pandemic," says Carlos del Rio, distinguished professor of medicine at Emory University School of Medicine.

Science advances in vaccine technology are the biggest bright spot this year, Fauci says.

  • Developing and then administering a safe and effective vaccine in 11 months is "a monumental accomplishment. It's just historic in its proportion," Fauci says.
  • "Rebuilding trust in science is a priority and I'm hoping the vaccines will do that.[cut: I think we need to continue to communicate what an incredible achievement that has been, and the fact that these vaccines did not come out of nowhere. Vaccines came from the years of research in mRNA technology and other things,]" Sell adds.

The bottom line: The pandemic has demonstrated that "the unimaginable can happen" Fauci says. But, he hopes "we're very, very much back to normal a year from now."

Go deeper

Rep. Lou Correa tests positive for COVID-19

Lou Correa. Photo: Tom Williams/CQ-Roll Call, Inc via Getty Images

Rep. Lou Correa (D-Calif.) announced on Saturday that he has tested positive for the coronavirus.

Why it matters: Correa is the latest Democratic lawmaker to share his positive test results after last week's deadly Capitol riot. Correa did not shelter in the designated safe zone with his congressional colleagues during the siege, per a spokesperson, instead staying outside to help Capitol Police.

Updated Jan 15, 2021 - Axios Events

Watch: Affordability and the next administration

On Friday, January 15, Axios' Caitlin Owens hosted a conversation on the future of health care affordability with a new Biden administration, featuring former CMS administrator Dr. Mark McClellan and former Rep. Greg Walden (R-Ore.)

Dr. Mark McClellan discussed the priorities of the incoming Biden administration and challenges in health care access and affordability exacerbated by the pandemic.

  • On President-elect Biden dealing with the pandemic: "[He] was elected above all else for an effective response to the crisis. And that means the first round of legislation has to focus on more effective vaccination, more effective testing, reopening the economy, and giving people the economic support they need."
  • On people not getting the care they need during the pandemic: "We've seen a lot of health care complications because people did not get help. We don't have a strong public health system in this country...Most people did not get help. If they were at risk for infections, they had to go find a way to get tested on their own."

Rep. Greg Walden unpacked the value of telemedicine and creating an affordable, patient-centered health care system.

  • How technology can bridge existing health gaps: "We've learned the importance and practicality of getting health care closer to the patient. I'm speaking specifically about telemedicine. I think it can be both cost-effective and so much more convenient for the patient...You shouldn't have to rush into a hospital for everything you need."

Axios Vice President Yolanda Taylor Brignoni hosted a View from the Top segment with the CEO of OptumHealth, UnitedHealth Group, Dr. Wyatt W. Decker, who discussed the pandemic as a moment for the industry to think differently about how they provide accessible care.

  • On the potential for telemedicine: "Let's put the decision-making, good information, and support in the hands of a person and help provide them with digital tools that can give them easy access to health care with excellent outcomes. We [can] do this in a whole variety of ways by providing telehealth solutions."

Thank you UnitedHealth Group for sponsoring this event.

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Health: CDC director defends agency's response to pandemic — CDC warns highly transmissible coronavirus variant could become dominant in U.S. in March.
  2. Politics: Biden readies massive shifts in policy for his first days in office.
  3. Vaccine: Fauci: 100 million doses in 100 days is "absolutely" doable.
  4. Economy: Unemployment filings explode again.
  5. Tech: Kids' screen time sees a big increase.
  6. World: WHO team arrives in China to investigate pandemic origins.