Serious questions are arising as to what’s true about Coronavirus after an offer to send a Centers for Disease Control team earlier this month to support China’s efforts to mitigate the outbreak of the infectious disease was denied, U.S. Health and Human Services Secretary Alex Azar announced in a news conference Tuesday.

“On January the 6th, we offered to send a CDC team to China that could assist with these public health efforts. I reiterated that offer when I spoke to China’s minister of health on Monday and it was reiterated again via the World Health Organization’s leadership today in Beijing,” Secretary Azar told reporters.

“We are urging China: more cooperation and transparency are the most important steps you can take toward a more effective response. Beyond that, all options for dealing with infectious disease spread have to be on the table including travel restrictions, but diseases are not terribly good at respecting borders, so we would have to assess carefully whether the evidence recommends any steps beyond the thoroughly tested methods I just described.”

The CDC has confirmed five cases of Coronavirus on U.S. soil. At the root of the outbreak in China, there are nearly 4,500 confirmed cases. Those numbers “understate the gravity of the situation,” according to Gordon Chang, an expert on China and Asian Affairs, who spoke to this reporter.

“There are a number of reasons for that and the most important of that of course is that they’re wanting to control the narrative, but they’re now talking about 4,500, which is a dramatic increase from yesterday and that of course is a step in the right direction, but they’re still so far off,” Chang said.

“For instance, over the weekend the University of Hong Kong did some modeling and they estimate that there were 44,000 infections in Wuhan alone as of Saturday, so clearly there is a discrepancy between that and the official numbers, which, you know, of course, officials are looking at confirmed cases and what the Hong Kong University people were doing was the modeling, but it shows you that a focus on the statistics that Beijing issues gives a distorted picture of what’s really happening because you have in Wuhan itself the place is in a state of lockdown,” he added.

The outbreak began on Dec. 8 when doctors in Wuhan confirmed the first case of the infectious disease. Since then, Wuhan and surrounding cities have been placed on lockdown, but the city’s mayor Zhou Xianwang says it wasn’t enough to stop its spread.

During an interview this week on China Central Television (CCTV), Xianwang said one of the roadblocks to information sharing is the requirement that local governments “need to get authorization” before public disclosure under China’s Infectious Disease Prevention and Treatment Law. Moreover, the mayor said the information hasn’t been turned over in a “timely” manner and was based on ineffective information.

“The Wuhan mayor said a lot of very interesting things. One of the other ones was that he really couldn’t act until he got instructions from the top from the central leadership,” said Chang. “In China’s system, bad news doesn’t travel very well up to the top and decisions can only be made at the top level on something like this so this rigid semi totalitarian political system is not moving quickly to deal with the virus.”