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The Reason for the WH and Dr. Birx Chilling New Probability Report

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Primer: We all seem to guess this except for Jim Acosta/CNN and the others at MSNBC. Media continues to blame the Trump White House for the slow response to address COVID-19, while Dr. Birx and Dr. Fauci explained what they did not know very early on. Now we know.

Now some real questions and new policy towards China must be considered. We can start with the $1.8 T in U.S. debt that China holds. The next is challenging American telecommunications companies to squelch China’s advances of 5G. Then there is the next phase of the U.S. trade agreement with China. Add in the mission to stop China’s power agenda across the globe as it is clear, China is fine with killing people and economies across the world.

China has concealed the extent of the coronavirus outbreak in its country, under-reporting both total cases and deaths it’s suffered from the disease, the U.S. intelligence community concluded in a classified report to the White House, according to three U.S. officials.

The officials asked not to be identified because the report is secret and declined to detail its contents. But the thrust, they said, is that China’s public reporting on cases and deaths is intentionally incomplete. Two of the officials said the report concludes that China’s numbers are fake.

The report was received by the White House last week, one of the officials said. The outbreak began in China’s Hubei province in late 2019, but the country has publicly reported only about 82,000 cases and 3,300 deaths, according to data compiled by Johns Hopkins University. That compares to more than 189,000 cases and more than 4,000 deaths in the U.S., which has the largest publicly reported outbreak in the world.

Communications staff at the White House and Chinese embassy in Washington didn’t immediately respond to requests for comment.

While China eventually imposed a strict lockdown beyond those of less autocratic nations, there has been considerable skepticism of China’s reported numbers, both outside and within the country. The Chinese government has repeatedly revised its methodology for counting cases, for weeks excluding people without symptoms entirely, and only on Tuesday added more than 1,500 asymptomatic cases to its total.

Stacks of thousands of urns outside funeral homes in Hubei province have driven public doubt in Beijing’s reporting.

Deborah Birx, the State Department immunologist advising the White House on its response to the outbreak, said Tuesday that China’s public reporting influenced assumptions elsewhere in the world about the nature of the virus.

Coronavirus: Doctor at hospital in China's Hubei province ... source

“The medical community made — interpreted the Chinese data as: This was serious, but smaller than anyone expected,” she said at a news conference on Tuesday. “Because I think probably we were missing a significant amount of the data, now that what we see happened to Italy and see what happened to Spain.”

China is not the only country with suspect public reporting. Western officials have pointed to Iran, Russia, Indonesia and especially North Korea, which has not reported a single case of the disease, as probable under-counts. Others including Saudi Arabia and Egypt may also be playing down their numbers.

U.S. Secretary of State Michael Pompeo has publicly urged China and other nations to be transparent about their outbreaks. He has repeatedly accused China of covering up the extent of the problem and being slow to share information, especially in the weeks after the virus first emerged, and blocking offers of help from American experts.

“This data set matters,” he said at a news conference in Washington on Tuesday. The development of medical therapies and public-health measures to combat the virus “so that we can save lives depends on the ability to have confidence and information about what has actually transpired,” he said.

“I would urge every nation: Do your best to collect the data. Do your best to share that information,” he said. “We’re doing that.”

The outbreak began in China’s Hubei province in late 2019, but the country has publicly reported only about 82,000 cases and 3,300 deaths, according to data compiled by Johns Hopkins University. That compares to more than 189,000 cases and more than 4,000 deaths in the U.S., which has the largest publicly reported outbreak in the world.

Map of sampling sites in the Hubei Province of China. Red ... source

 

Abstract

Background: The COVID-19 outbreak containment strategies in China based on non-pharmaceutical interventions (NPIs) appear to be effective. Quantitative research is still needed however to assess the efficacy of different candidate NPIs and their timings to guide ongoing and future responses to epidemics of this emerging disease across the World. Methods: We built a travel network-based susceptible-exposed-infectious-removed (SEIR) model to simulate the outbreak across cities in mainland China. We used epidemiological parameters estimated for the early stage of outbreak in Wuhan to parameterise the transmission before NPIs were implemented. To quantify the relative effect of various NPIs, daily changes of delay from illness onset to the first reported case in each county were used as a proxy for the improvement of case identification and isolation across the outbreak. Historical and near-real time human movement data, obtained from Baidu location-based service, were used to derive the intensity of travel restrictions and contact reductions across China. The model and outputs were validated using daily reported case numbers, with a series of sensitivity analyses conducted. Results: We estimated that there were a total of 114,325 COVID-19 cases (interquartile range [IQR] 76,776 – 164,576) in mainland China as of February 29, 2020, and these were highly correlated (p<0.001, R2=0.86) with reported incidence. Without NPIs, the number of COVID-19 cases would likely have shown a 67-fold increase (IQR: 44 – 94), with the effectiveness of different interventions varying. The early detection and isolation of cases was estimated to prevent more infections than travel restrictions and contact reductions, but integrated NPIs would achieve the strongest and most rapid effect. If NPIs could have been conducted one week, two weeks, or three weeks earlier in China, cases could have been reduced by 66%, 86%, and 95%, respectively, together with significantly reducing the number of affected areas. However, if NPIs were conducted one week, two weeks, or three weeks later, the number of cases could have shown a 3-fold, 7-fold, and 18-fold increase across China, respectively. Results also suggest that the social distancing intervention should be continued for the next few months in China to prevent case numbers increasing again after travel restrictions were lifted on February 17, 2020. Conclusion: The NPIs deployed in China appear to be effectively containing the COVID-19 outbreak, but the efficacy of the different interventions varied, with the early case detection and contact reduction being the most effective. Moreover, deploying the NPIs early is also important to prevent further spread. Early and integrated NPI strategies should be prepared, adopted and adjusted to minimize health, social and economic impacts in affected regions around the World.

 

(PanCAP)SynchronizationMatrix-COVID-19 Plan

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The Defense Production Act. Read it here.

The president invoked the act Wednesday during a White House news briefing with members of the Coronavirus Task Force.

“It can do a lot of good things if we need it,” the president told reporters.

Image result for defense production act source

 

The 1950 act was periodically used during both the Korean War and throughout the Cold War, and was last invoked in June 2017 by Trump to provide technology in the space industrial base.

This is not about what the Federal government can provide, but rather the Federal government authorizing and hiring private business to produce products and service to fulfill the needs for the good of the nation. That is where innovation and capitalism works.

President Trump is pulling all the levers of government and plowing his way through regulations and bureaucracy. It is big and messy mostly because of Obamacare which installed 23000 pages of regulations. The PANCAP plan is found here in full. Additional levers are being created to stop the economic and financial damage the the nation.

Meanwhile, media has attacked President Trump for using the term ‘China virus’ and he defended that use, rightly so. The medical community uses several variations of the same phrase. It is about China and has been for decades. World leaders have challenged China for countless years over their reckless laws and lack of food, people, animal and health protections. I have seen it personally myself being in mainland China many years ago. I visited those wet markets where the food supply and lack of safety is not only disgusting but deadly. Truth be told, trafficking and breeding animals for food in China is estimated to be a $76 billion industry.

For perspective, this short video is a must watch.

Relations between the West and China has taken on a new attitude and approach and rightly so. The discussions should begin with China paying trillions in reparations to nations affected by not only the Covid-19 virus but even previous virus outbreaks as well. China holds an estimated $1.7 trillion of U.S. debt. China should forgive that debt today.

From an article written by Michael Auslin in part mentions:

Those concerned with global health issues may wonder why it is that China is wracked regularly by viral epidemics in addition to coronavirus, such as SARS, African Swine Fever, and avian flu (another outbreak is happening right now). Others may begin to look more carefully at China’s environmental devastation and the hundreds of thousands of premature deaths each year from air and water pollution.

On the trade side, many foreign corporations already have been reconsidering their operations in China, due to rampant intellectual property theft and rising production costs; now, they may seriously question how safe it is to continue to do business in China. Not only is the health of their employees at risk, but they no longer can be assured that China will be a stable supplier. If coronavirus becomes a seasonal phenomenon, as some experts predict, then even with a vaccine, new strains of the pathogen will always raise the specter of another out-of-control epidemic overwhelming the party-state’s capabilities and infecting the rest of the world.

China has a plan to be the world’s dominant power, what better way to achieve that mission than to infect the globe with a pandemic causing financial collapse? To prevent the China mission, Western nations must reassert nationalism including manufacturing and install policy that never allows vulnerabilities to health and national security, this includes 5G. China and Russia cannot be allowed to win much less have any kind of advantage over other nations.

U.S. citizens are very crafty, innovative and resourceful and given these skills and spirit, this will pass quickly.

 

California Bullet Train, Shut-up About Fleecing the Government

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Exactly how come Senators Kamala Harris and Dianne Feinstein have nothing to say? Pelosi? Nah….
When Mark Styles was hired in October 2018 to help oversee Central Valley scheduling for the California bullet train, he soon learned he had walked into a mess.
Over the previous half decade the project had repeatedly fallen behind schedule, and the cost by 2018 had jumped from $64 billion to $77 billion in two years.
California is Building High-Speed Rail | High Speed Rail ...
A core problem was the project’s operating culture, in which managers for WSP, the bullet train’s lead consultant, threatened to punish or terminate employees if they failed to toe the company line, Styles said.
“I was told to shut up and not say anything,” said Styles, a career construction manager who was hired as WSP’s senior supervisory scheduler in the project’s Fresno office. “I was told that I didn’t understand the political arena the project was in. I told them I am not going to shut up. This is my job.”
The atmosphere described by Styles has been corroborated by a half dozen current and former senior officials knowledgeable about the project’s Fresno office.
The officials say it helps explain why California’s high-speed rail endeavor has barreled ahead for more than a decade, despite warnings it was structured on risky assumptions and could run out of money before any trains operate.
WSP spokeswoman Denise Turner Roth rejected Styles’ claims. “We always work carefully with our client to evaluate the demands of each project and to prepare realistic and transparent recommendations regarding schedule and budget,” she said.
But other ex-WSP employees in the Fresno office, including engineer Vera Lovejoy and project controls coordinator Todd Bilstein, say they were also discouraged from sharing bad news with bosses.
“I wanted the project to succeed,” said Lovejoy, who left the project in 2019 after one year. “I was eager to help deliver it. But I couldn’t stay. If you rock the boat, you are labeled as not a team player.”
Bilstein also left in 2019 after a nine-month tenure.
“If I was to give a talk at a construction conference, I would say they were not following generally accepted project management principles,” he said. The company’s failures, he said, ran the gamut of estimating costs, scheduling construction and managing change orders.
“Revealing bad news was discouraged,” he added. “I just couldn’t continue to work there. I don’t work that way. American professionals don’t work that way.”
Styles, who has no lawsuit or other legal claims, is also no longer with WSP. He left in November, calling it “the worst job of my career,” and moved to a new construction job out of state.
Brian Kelly, chief executive of the California High-Speed Rail Authority, said in a statement that the agency “takes seriously any claim of wrongdoing by an employee or contractor. We have procedures in place for any such claim to be raised and reviewed. We have an expectation that all employees act within the law and that our contractors meet the requirements of state and federal law.”
He added in an interview, “Our focus is on the mission in front of us.”
In the last half year, Kelly has moved to make changes in his organization’s culture, replacing numerous middle-level management officials, orchestrating more documentation for its plans and vowing to improve transparency in the agency operations.
WSP and Parsons Brinckerhoff, which merged in 2014, have been on the project since the 1990s. The Montreal firm, one of the largest infrastructure engineering organizations, is working under a $666-million contract. When he arrived at the project’s Fresno office, Styles said, he found a dysfunctional operation like he had never seen before — a pressured environment that aimed to contain bad news that could damage the project’s fortunes.
At the time, the rail authority was confronting delay claims, resulting from its slow acquisition of land, and change orders — both amounting to millions of dollars in higher costs.
Within days, he asked to see the detailed justification documents for the change orders. He said he wanted to understand the delays and how they would affect future construction, a routine part of a scheduler’s job.
WSP management, he said, told him that he didn’t need to see the documents. WSP was pushing to “keep the numbers looking good,” which in some cases involved altering reports written by its staff to make construction progress look better, he alleges.
Styles and other sources speaking off the record say that the bullet train schedule, which calls for installing 119 miles of track and a complex signal system from Madera to Wasco by 2022, is “impossible,” even though the project’s budget is predicated on the completion date.
To install track by 2022 would normally require all of the bridges, viaducts, trenches and other structures to be completed beforehand. As a stopgap measure, the rail authority now plans to install track in five-mile discontinuous segments, which the Federal Railroad Administration has criticized as illogical.
A more likely scenario would have the current construction completed between 2025 and 2028, which would drive costs up and force the state to either find new money or curtail the project, Styles and others said.
Rail authority spokeswoman Annie Parker said the agency has acknowledged repeatedly that “the deadline is a challenge.” It will require boosting monthly construction spending from the current $46 million to $70 million, said chief financial officer Brian Annis, who added that its construction pace is improving.
Sylmar-based Tutor Perini, which is building rail structures in Madera and Fresno counties, said a week ago it will complete its work in 2023. The company’s contract was initially $1 billion, but delay claims and change orders have doubled the amount.
Chief Executive Ron Tutor told security analysts in a recorded telephone call on Feb. 26, “With our extending the completion date from the end of ’21 to the first quarter of ’23, once again, we are in discussions with the owner to resolve payment for that further delay. However, it seems certain that given all of the results and resolves over the last 90 days that that should be the final end date for high-speed rail.”
It would mean that the rail authority could not begin to install track and signals until after that construction is completed.
When The Times asked the rail authority if it had comment on Tutor’s statement, it received an email Friday from Tutor saying his statement to investors had caused “some confusion.” He said that he hopes that “substantial completion” of his company’s work would occur in early 2022, leaving “paperwork, acceptances and contractual documentation” to be completed in early in 2023.
Turning around the multibillion-dollar project has proved difficult for years, given California’s complex governance structure, flawed contracts and past decisions, officials close to the project say. Executives in civil engineering firms say the rail authority lacks technical resources.
“They have all these people in top jobs with no technical background,” said a top executive at a major European engineering firm, who worked on the project. “They are politicians. They never disclose the full cost. They give you incremental truth. They believe that is a successful business model. They should cancel the contracts and start over.”
The Federal Railroad Administration, which oversees billions of dollars in grants, has long warned the rail authority it risked missing deadlines and was headed for big cost overruns. In December 2016, the FRA warned the statethat the cost of the Central Valley construction could jump by $3.6 billion. After The Times obtained a copy of the confidential report and published its findings, the rail authority denied the legitimacy of the analysis. Today, the cost is even higher than the FRA projected.
WSP said it stands by the job it is doing for the bullet train. “To the extent WSP prepares cost and schedule estimates for the program as a whole, WSP brings world-class talent to the project that prepare professional estimates based on client needs and the information available when generated,” Turner Roth said.
Styles said he was shut out of work not long after taking the job at WSP, though the company did not fire him. Over many months, Styles, who was being paid $170,000 annually, said he kept advising management about the problems and writing procedures for contract compliance.
In a Facebook posting in June, Styles wrote that he had been warned by a co-worker “to be careful” and “you know too much” and to take a lower profile. “I’d rather be dead than a coward,” he wrote.
Styles filed an ethics complaint against his former employer in June, which was examined by a management committee in Chicago. “The committee concluded there was no proof that WSP violated ethics with the state,” he said.
Turner Roth said, “In 2019, an employee — who has since left the company — raised a question about the schedule data submitted to WSP by the construction managers and construction contractors. In response to this question, WSP thoroughly investigated the matter, and concluded there was no wrongful conduct by WSP employees in their review of contractor submissions.”
As for Lovejoy, whose career includes engineering jobs at major public agencies and corporations, she said problems started more a decade ago when the Obama administration issued a $2.5-billion grant from its economic stimulus program, intended for “shovel-ready projects.”
The grant came about four years before the first construction contract was issued, and actual work did not begin for two more years. “It was so far from shovel-ready,” Lovejoy said.
Another former WSP employee, who spoke anonymously out of concern that he would face retribution, supported Styles’ assertion that monthly and annual reports submitted by staff often were changed by WSP management before they were reviewed in meetings and sent to state executives.
“We gave them the bad news and they wouldn’t accept it,” he said.
The Times has previously reported that the project has struggled to relocate pipes, electrical lines and other infrastructure that stands in the way of securing parcels and laying track. Today, the rail authority is short by 497 of the 2,042 parcels it needs, according to its most recent progress report. In December, the authority acquired only five parcels.
In late 2018, Hemanth Kundeti, a database manager, was hired into the project to help improve property records, but he lasted only several months.
Kundeti, an employee of a subconsultant to WSP, said he developed his own software tool that could track the work more accurately. It would have allowed the state to replace a subcontractor that was charging $2 million annually to maintain the records, he said.
When he proposed the tool to WSP and state officials, it was rejected. In February 2019, he was twice reprimanded for “insubordination” for continuing to promote his software, according to a copy of the reprimand. In response, he wrote on his warning letter that management “without healthy debate is dangerous for any organization.” He was terminated a few weeks later.
“I am still reeling from the after-effects of being terminated for trying to save taxpayers’ money from being wasted,” said Kundeti, who has found a new job.

Taiwan More Advanced than U.S. to Deal with Coronavirus

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Taiwan, while in a contentious government power struggle with China, the country has a very conservative approach on economic stability and encourages entrepreneurial strengths.

(Reuters) – China is pressuring Taiwan with “provocative” air force maneuvers near the island and spreading fake news to sow discord during the coronavirus outbreak, security sources and government officials in Taiwan say.

This sets the table for why Taiwan’s master plan to thrive during the coronavirus outbreak.

Angry Taiwan blames China for UN aviation meet snub | The ...

You can be assured corporate leaders in the United States are taking notice and are hosting some top level meetings regarding research and development across the country during this anxious time in America and across the world.

Taiwan records its first coronavirus death as global toll ...

Read on for some interesting actions Taiwan has taken given how interacted the country is with China.

***

Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of coronavirus disease 2019 (COVID-19) due to its proximity to and number of flights between China.1 The country has 23 million citizens of which 850 000 reside in and 404 000 work in China.2,3 In 2019, 2.71 million visitors from the mainland traveled to Taiwan.4 As such, Taiwan has been on constant alert and ready to act on epidemics arising from China ever since the severe acute respiratory syndrome (SARS) epidemic in 2003. Given the continual spread of COVID-19 around the world, understanding the action items that were implemented quickly in Taiwan and assessing the effectiveness of these actions in preventing a large-scale epidemic may be instructive for other countries.

COVID-19 occurred just before the Lunar New Year during which time millions of Chinese and Taiwanese were expected to travel for the holidays. Taiwan quickly mobilized and instituted specific approaches for case identification, containment, and resource allocation to protect the public health. Taiwan leveraged its national health insurance database and integrated it with its immigration and customs database to begin the creation of big data for analytics; it generated real-time alerts during a clinical visit based on travel history and clinical symptoms to aid case identification. It also used new technology, including QR code scanning and online reporting of travel history and health symptoms to classify travelers’ infectious risks based on flight origin and travel history in the past 14 days. Persons with low risk (no travel to level 3 alert areas) were sent a health declaration border pass via SMS (short message service) messaging to their phones for faster immigration clearance; those with higher risk (recent travel to level 3 alert areas) were quarantined at home and tracked through their mobile phone to ensure that they remained at home during the incubation period.

Moreover, Taiwan enhanced COVID-19 case finding by proactively seeking out patients with severe respiratory symptoms (based on information from the National Health Insurance [NHI] database) who had tested negative for influenza and retested them for COVID-19; 1 was found of 113 cases. The toll-free number 1922 served as a hotline for citizens to report suspicious symptoms or cases in themselves or others; as the disease progressed, this hotline has reached full capacity, so each major city was asked to create its own hotline as an alternative. It is not known how often this hotline has been used. The government addressed the issue of disease stigma and compassion for those affected by providing food, frequent health checks, and encouragement for those under quarantine. This rapid response included hundreds of action items (eTable in the Supplement).

Recognizing the Crisis

In 2004, the year after the SARS outbreak, the Taiwan government established the National Health Command Center (NHCC). The NHCC is part of a disaster management center that focuses on large-outbreak response and acts as the operational command point for direct communications among central, regional, and local authorities. The NHCC unified a central command system that includes the Central Epidemic Command Center (CECC), the Biological Pathogen Disaster Command Center, the Counter-Bioterrorism Command Center, and the Central Medical Emergency Operations Center.5

On December 31, 2019, when the World Health Organization was notified of pneumonia of unknown cause in Wuhan, China, Taiwanese officials began to board planes and assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane. As early as January 5, 2020, notification was expanded to include any individual who had traveled to Wuhan in the past 14 days and had a fever or symptoms of upper respiratory tract infection at the point of entry; suspected cases were screened for 26 viruses including SARS and Middle East respiratory syndrome (MERS). Passengers displaying symptoms of fever and coughing were quarantined at home and assessed whether medical attention at a hospital was necessary. On January 20, while sporadic cases were reported from China, the Taiwan Centers for Disease Control (CDC) officially activated the CECC for severe special infectious pneumonia under NHCC, with the minister of health and welfare as the designated commander. The CECC coordinated efforts by various ministries, including the ministries of transportation, economics, labor, and education and the Environmental Protection Administration, among others, in a comprehensive effort to counteract the emerging public health crisis.

Managing the Crisis

For the past 5 weeks (January 20-February 24), the CECC has rapidly produced and implemented a list of at least 124 action items (eTable in the Supplement) including border control from the air and sea, case identification (using new data and technology), quarantine of suspicious cases, proactive case finding, resource allocation (assessing and managing capacity), reassurance and education of the public while fighting misinformation, negotiation with other countries and regions, formulation of policies toward schools and childcare, and relief to businesses.

Border Control, Case Identification, and Containment

On January 27, the National Health Insurance Administration (NHIA) and the National Immigration Agency integrated patients’ past 14-day travel history with their NHI identification card data from the NHIA; this was accomplished in 1 day. Taiwan citizens’ household registration system and the foreigners’ entry card allowed the government to track individuals at high risk because of recent travel history in affected areas. Those identified as high risk (under home quarantine) were monitored electronically through their mobile phones. On January 30, the NHIA database was expanded to cover the past 14-day travel history for patients from China, Hong Kong, and Macau. On February 14, the Entry Quarantine System was launched, so travelers can complete the health declaration form by scanning a QR code that leads to an online form, either prior to departure from or upon arrival at a Taiwan airport. A mobile health declaration pass was then sent via SMS to phones using a local telecom operator, which allowed for faster immigration clearance for those with minimal risk. This system was created within a 72-hour period. On February 18, the government announced that all hospitals, clinics, and pharmacies in Taiwan would have access to patients’ travel histories.

Resource Allocation: Logistics and Operations

The CECC took an active role in resource allocation, including setting the price of masks and using government funds and military personnel to increase mask production. On January 20, the Taiwan CDC announced that the government had under its control a stockpile of 44 million surgical masks, 1.9 million N95 masks, and 1100 negative-pressure isolation rooms.

Communications and Politics
Reassure and Educate the Public, While Fighting Misinformation

In addition to daily press briefings by the minister of health and welfare the CECC, the vice president of Taiwan, a prominent epidemiologist, gave regular public service announcements broadcast from the office of the president and made available via the internet. These announcements included when and where to wear a mask, the importance of handwashing, and the danger of hoarding masks to prevent them from becoming unavailable to frontline health workers. The CECC also made plans to assist schools, businesses, and furloughed workers (eTable in the Supplement).

Taiwan’s Outcomes so Far (as of February 24)
Interim Outcomes

The CECC has communicated to the public in a clear and compassionate manner. Based on a poll of 1079 randomly selected people conducted by the Taiwan Public Opinion Foundation on February 17 and 18, the minister of health and welfare received approval ratings of more than 80% for his handling of the crisis, and the president and the premier received an overall approval rating of close to 70%. As of February 24, Taiwan has 30 cases of COVID-19. These cases represent the 10th-highest case number among countries affected thus far, but far fewer than the initial models predicting that Taiwan would have the second-highest importation risk.

Challenges

First, real-time public communications were mostly in Mandarin Chinese and sign language. Other than the Taiwan CDC website, there was not enough communication in different languages to non-Taiwanese citizens traveling or residing in Taiwan. Second, while its attention was focused on air travel, Taiwan permitted the docking of the Diamond Princess cruise ship and allowed passengers to disembark in Keelung, near New Taipei City, on January 31, before the ship left for Japan. The ship was subsequently found to have numerous confirmed infections onboard. This created a temporary public panic with concern about community spread. The government published the 50 locations where the cruise ship travelers may have visited and asked citizens who may have been in contact with the tour group to conduct symptom monitoring and self-quarantine if necessary. None were confirmed to have COVID-19 after 14 days had passed. Third, whether the intensive nature of these policies can be maintained until the end of the epidemic and continue to be well received by the public is unclear.

Conclusions

Taiwan’s government learned from its 2003 SARS experience and established a public health response mechanism for enabling rapid actions for the next crisis. Well-trained and experienced teams of officials were quick to recognize the crisis and activated emergency management structures to address the emerging outbreak.

In a crisis, governments often make difficult decisions under uncertainty and time constraints. These decisions must be both culturally appropriate and sensitive to the population. Through early recognition of the crisis, daily briefings to the public, and simple health messaging, the government was able to reassure the public by delivering timely, accurate, and transparent information regarding the evolving epidemic. Taiwan is an example of how a society can respond quickly to a crisis and protect the interests of its citizens.

Article Information

Corresponding Author: C. Jason Wang, MD, PhD, Stanford University, 117 Encina Commons, CHP/PCOR, Stanford, CA 94305 ([email protected]).

Published Online: March 3, 2020. doi:10.1001/jama.2020.3151

Conflict of Interest Disclosures: None reported.

References and footnotes found here in detail.

Gadgets for Tech Giants Made with Coerced Uighur Labor

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NANCHANG, China (AP) — In a lively Muslim quarter of Nanchang city, a sprawling Chinese factory turns out computer screens, cameras and fingerprint scanners for a supplier to international tech giants such as Apple and Lenovo. Throughout the neighborhood, women in headscarves stroll through the streets, and Arabic signs advertise halal supermarkets and noodle shops.

In this June 5, 2019, photo, residents of the Hui Muslim ethnic minority walk in a neighborhood near an OFILM factory in Nanchang in eastern China’s Jiangxi province. The Associated Press has found that OFILM, a supplier of major multinational companies, employs Uighurs, an ethnic Turkic minority, under highly restrictive conditions, including not letting them leave the factory compound without a chaperone, worship, or wear headscarves. (AP Photo/Ng Han Guan)

Yet the mostly Muslim ethnic Uighurs who labor in the factory are isolated within a walled compound that is fortified with security cameras and guards at the entrance. Their forays out are limited to rare chaperoned trips, they are not allowed to worship or cover their heads, and they must attend special classes in the evenings, according to former and current workers and shopkeepers in the area.

The connection between OFILM, the supplier that owns the Nanchang factory, and the tech giants is the latest sign that companies outside China are benefiting from coercive labor practices imposed on the Uighurs, a Turkic ethnic group, and other minorities.

Over the past four years, the Chinese government has detained more than a million people from the far west Xinjiang region, most of them Uighurs, in internment camps and prisons where they go through forced ideological and behavioral re-education. China has long suspected the Uighurs of harboring separatist tendencies because of their distinct culture, language and religion.

When detainees “graduate” from the camps, documents show, many are sent to work in factories. A dozen Uighurs and Kazakhs told the AP they knew people who were sent by the state to work in factories in China’s east, known as inner China — some from the camps, some plucked from their families, some from vocational schools. Most were sent by force, although in a few cases it wasn’t clear if they consented.

Workers are often enrolled in classes where state-sponsored teachers give lessons in Mandarin, China’s dominant language, or politics and “ethnic unity.” Conditions in the jobs vary in terms of pay and restrictions.

At the OFILM factory, Uighurs are paid the same as other workers but otherwise treated differently, according to residents of the neighborhood. They are not allowed to leave or pray – unlike the Hui Muslim migrants also working there, who are considered less of a threat by the Chinese government.

“They don’t let them worship inside,” said a Hui Muslim woman who worked in the factory for several weeks alongside the Uighurs. “They don’t let them come out.”

“If you’re Uighur, you’re only allowed outside twice a month,” a small business owner who spoke with the workers confirmed. The AP is not disclosing the names of those interviewed near the factory out of concern for possible retribution. “The government chose them to come to OFILM, they didn’t choose it.”

The Chinese government says the labor program is a way to train Uighurs and other minorities and give them jobs. The Chinese Ministry of Foreign Affairs on Monday called concern over possible coerced labor under the program “groundless” and “slander.”

However, experts say that like the internment camps, the program is part of a broader assault on the Uighur culture, breaking up social and family links by sending people far from their homes to be assimilated into the dominant Han Chinese culture.

“They think these people are poorly educated, isolated, backwards, can’t speak Mandarin,” said James Leibold, a scholar of Chinese ethnic policy at La Trobe University in Melbourne. “So what do you do? You ‘educate’ them, you find ways to transform them in your own image. Bringing them into the Han Chinese heartland is a way to turbocharge this transformation.”

OFILM’s website indicates the Xinjiang workers make screens, camera cover lenses and fingerprint scanners. It touts customers including Apple, Samsung, Lenovo, Dell, HP, LG and Huawei, although there was no way for the AP to track specific products to specific companies.

Apple’s most recent list of suppliers, published January last year, includes three OFILM factories in Nanchang. It’s unclear whether the specific OFILM factory the AP visited twice in Nanchang supplies Apple, but it has the same address as one listed. Another OFILM factory is located about half a mile away on a different street. Apple did not answer repeated requests for clarification on which factory it uses.

In an email, Apple said its code of conduct requires suppliers to “provide channels that encourage employees to voice concerns.” It said it interviews the employees of suppliers during annual assessments in their local language without their managers present, and had done 44,000 interviews in 2018.

Lenovo confirmed that it sources screens, cameras, and fingerprint scanners from OFILM but said it was not aware of the allegations and would investigate. Lenovo also pointed to a 2018 audit by the Reliable Business Alliance in which OFILM scored very well.

All the companies that responded said they required suppliers to follow strict labor standards. LG and Dell said they had “no evidence” of forced labor in their supply chains but would investigate, as did Huawei. HP did not respond.

OFILM also lists as customers dozens of companies within China, as well as international companies it calls “partners” without specifying what product it offers. And it supplies PAR Technology, an American sales systems vendor to which it most recently shipped 48 cartons of touch screens in February, according to U.S. customs data obtained through ImportGenius and Panjiva, which track shipping data.

PAR Technology in turn says it supplies terminals to major chains such as McDonald’s, Taco Bell, and Subway. However, the AP was unable to confirm that products from OFILM end up with the fast food companies.

McDonald’s said it has asked PAR Technology to discontinue purchases from OFILM while it launches an immediate investigation. PAR Technology also said it would investigate immediately. Subway and Taco Bell did not respond.

A report Sunday from the Australian Strategic Policy Institute, researched separately from the AP, estimated that more than 80,000 Uighurs were transferred from Xinjiang to factories across China between 2017 and 2019. The report said it found “conditions that strongly suggest forced labor” consistent with International Labor Organization definitions.

The AP also reported a year ago that Uighur forced labor was being used within Xinjiang to make sportswear that ended up in the U.S.

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FROM FARMERS TO FACTORY WORKERS

Beijing first sent Uighurs to work in inland China in the early 2000s, as part of a broad effort to push minorities to adopt urban lifestyles and integrate with the Han Chinese majority to tighten political control.

At first the program targeted young, single women, because the state worried that Uighur women raised in pious Muslim families didn’t work, had children early and refused to marry Han men. But as stories of poor pay and tight restrictions trickled back, police began threatening some parents with jail time if they didn’t send their children, six Uighurs told the AP.

The program was halted in 2009, when at least two Uighurs died in a brawl with Han workers at a toy factory in coastal Guangdong province. After peaceful protests in Xinjiang were met with police fire, ethnic riots broke out that killed an estimated 200 people, mostly Han Chinese civilians.

An AP review of Chinese academic papers and state media reports shows that officials blamed the failure of the labor program on the Uighurs’ language and culture. So when the government ramped up the program again after the ascent of hardline Chinese President Xi Jinping in 2012, it emphasized ideological transformation.

A paper drafted by the head of the Xinjiang statistics bureau in 2014 said the Uighurs’ poor Mandarin made it hard for them to integrate in inner China. It concluded that Xinjiang’s rural minorities needed to be broken away from traditional lifestyles and systematically “disciplined”, “trained” and “instilled with modern values.”

“The local saturated religious atmosphere and the long-time living habits of ethnic minorities are incompatible with the requirements of modern industrial production,” the paper said. It outlined a need to “slowly correct misunderstandings about going out to choose jobs.”

Before Uighurs were transferred for jobs, the paper continued, they needed to be trained and assessed on their living habits and adoption of corporate culture.

“Those who fail will not be exported,” it said.

The paper also described government incentives such as tax breaks and subsidies for Chinese companies to take Uighurs. A 2014 draft contract for Xinjiang laborers in Guangdong province obtained by the AP shows the government there offered companies 3000 RMB ($428.52) per worker, with an additional 1000 RMB ($142.84) for “training” each person for no less than 60 class hours. In exchange, companies had to offer “concentrated accommodation areas,” halal canteens and “ethnic unity education and training.”

But it was a tough sell at a time when Chinese officials were grappling with knifings, bombings and car attacks by Uighurs, fueled by explosive anger at the government’s harsh security measures and religious restrictions. Hundreds died in race-related violence in Xinjiang, both Uighur and Han Chinese.

A labor agent who only gave his surname, Zhang, said he tried brokering deals to send Xinjiang workers to factories in the eastern city of Hangzhou, but finding companies willing to take Uighurs was a challenge, especially in a slowing economy.

“Their work efficiency is not high,” he said.

The size of the program is considerable. A November 2017 state media report said Hotan prefecture alone planned to send 20,000 people over two years to work in inner China.

There, the report said, they would “realize the dreams of their lives.”

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ANSWERING THE GOVERNMENT’S CALL

The Uighurs at OFLIM were sent there as part of the government’s labor program, in an arrangement the company’s website calls a “school-enterprise cooperative.” OFILM describes the workers as migrants organized by the government or vocational school students on “internships”.

OFILM confirmed it received AP requests for comment but did not reply.

The AP was unable to get inside the facility, and on one visit to Nanchang, plainclothes police tailed AP journalists by car and on foot. But posts on the company website extoll OFILM’s efforts to accommodate their Uighur workers with Mandarin and politics classes six days a week, along with halal food.

OFILM first hired Uighurs in 2017, recruiting over 3,000 young men and women in Xinjiang. They bring the Uighurs on one- or two-year contracts to Nanchang, a southeastern metropolis nearly two thousand miles from Xinjiang that local officials hope to turn into a tech hub.

OFILM is one of Nanchang’s biggest employers, with half a dozen factory complexes sprinkled across the city and close ties with the state. Investment funds backed by the Nanchang city government own large stakes in OFILM, corporate filings show. The Nanchang government told the AP that OFILM recruits minorities according to “voluntary selection by both parties” and provides equal pay along with personal and religious freedom.

OFILM’s website says the company “answered the government’s call” and went to Xinjiang to recruit minorities. The Uighurs need training, OFILM says, to pull them from poverty and help them “study and improve.”

Mandarin is heavily emphasized, the site says, as well as lessons in history and “ethnic unity” to “comprehensively improve their overall quality.” The site features pictures of Uighurs playing basketball on factory grounds, dancing in a canteen and vying in a Mandarin speech competition.

In August, when OFILM organized celebrations for Eid Qurban, a major Islamic festival, Uighur employees did not pray at a mosque. Instead, they dressed in orange uniforms and gathered in a basketball court for a show with Communist officials called “Love the Motherland – Thank the Party.” An OFILM post said a “Uighur beauty” dazzled with her “beautiful exotic style.”

State media reports portray the Nanchang factory workers as rural and backwards before the Communist Party trained them, a common perception of the Uighurs among the Han Chinese.

“The workers’ concept of time was hazy, they would sleep in till whenever they wanted,” a Party official is quoted as saying in one. Now, he said, their “concept of time has undergone a total reversal.”

In the reports and OFILM posts, the Uighurs are portrayed as grateful to the Communist Party for sending them to inner China.

Despite the wan expressions of three OFILM workers from Lop County, a December 2017 report said they gave an “enthusiastic” presentation about how they lived in clean new dormitories “much better than home” and were visited by Communist Party cadres.

“We were overjoyed that leaders from the Lop County government still come to see us on holidays,” one of the workers, Estullah Ali, was quoted as saying. “Many of us were moved to tears.”

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THEY TOOK MY CHILD TO INNER CHINA

Minorities fleeing China describe a far grimmer situation. H., a wealthy jade merchant from Lop County, where OFILM now gets Uighur workers, began noticing the labor transfer program in 2014. That’s when state propaganda blaring through television and loudspeakers urged young Uighurs to work in inner China. Officials hustled families to a labor transfer office where they were forced to sign contracts, under threat of land confiscations and prison sentences.

H., identified only by the initial of his last name out of fear of retribution, was worried. The government was not only reviving the labor program but also clamping down on religion. Acquaintances vanished: Devout Muslims and language teachers, men with beards, women with headscarves.

Toward the end of 2015, when H. greeted his 72-year-old neighbor on the street, the man burst into tears.

“They took my child to inner China to work,” he said.

Months later, H. and his family fled China.

Zharqynbek Otan, a Chinese-born ethnic Kazakh, said that after he was released from an internment camp in 2018, neighbors in his home village also told him their sons and daughters were forced to sign contracts for 6 months to five years to work at factories near Shanghai. If they ran from the factories, they were warned, they’d be taken straight back to internment camps.

Nurlan Kokteubai, an ethnic Kazakh, said during his time in an internment camp, a cadre told him they selected young, strong people to work in inner Chinese factories in need of labor.

“He told us that those young people would acquire vocational skills,” Kokteubai said.

Not all workers are subject to the restrictions at OFILM. One ethnic Kazakh said her brother made power banks in central China for $571.36 a month and didn’t take classes.

But another said two of his cousins were forced to go and work in cold, harsh conditions. They were promised $428.52 a month but paid only $42.85. Though they wanted to quit, four Uighurs who complained were detained in camps after returning to Xinjiang, scaring others.

Uighurs and Kazakhs in exile say it’s likely those working in inner China are still better off than those in camps or factories in Xinjiang, and that in the past, some had gone voluntarily to earn money. A former worker at Jiangxi Lianchuang Electronics, a lens maker in Nanchang, told The Associated Press the 300 or so Uighurs there were free to enter or leave their compound, although most live in dormitories inside factory grounds. He and a current worker said they were happy with their working conditions, their salary of about 5,000 RMB ($714.20) a month, and their teachers and Mandarin classes in the evenings.

But when presented a list of questions in Uighur about the labor transfers, the former Jiangxi Lianchuang worker started to look very nervous. He asked for the list, then set it on fire with a lighter and dropped it in an ashtray.

“If the Communist Party hears this, then” – he knocked his wrists together, mimicking a suspect being handcuffed. “It’s very bad.”