Coronavirus Probe: WHO, What, and When?
Findings of the WHO investigative mission to Wuhan
In January, a team of 10 international experts from the World Health Organization (WHO) arrived in China on a 28-day mission. Their aim was to probe into the cause of the origins of COVID-19 — the earliest cases believed to have been workers at the Huanan Seafood Wholesale Market in Wuhan, where 10,000 people visit each day.
Chosen to represent Australia was Professor Dominic Dwyer, a microbiologist and Clinical Professor of Medicine for Immunology and Infectious Diseases at the University of Sydney’s School of Medicine, who spoke to Hamodia about his impressions and findings.
Which participants were on the WHO mission to investigate the origins of COVID-19?
The joint study team was comprised of 10 independent experts from Australia, Denmark, Netherlands, Russia, U.K., Qatar, Vietnam, USA, Germany and Japan, plus seven experts and support staff. The American representative was Peter Daszak, president of EcoHealth Alliance, USA.
There were also representatives from WHO’s responses to outbreaks, GOARN (Global Outbreak Alert and Response Network), and some experts from the Food and Agricultural Organization, as well as representatives from animal health organizations.
Also, there was a team of 17 people from China that was organized by the National Health Commission (which is the Ministry of Health).
What was your role?
I was involved in understanding the early spread of the virus in Wuhan, through the market and outside the markets and also in reviewing some of the work on the genetic structure of the viruses that were involved in those early days.
Where did you begin your investigation?
In late 2020, when the call went out for this team, we met on Zoom to work out the strategies for this mission including: what information we wanted, what data we required to get from China that might help us explain the origin of the virus, and what studies needed to be done.
During our two weeks of quarantine in Wuhan, the team, including our Chinese colleagues, spoke via Zoom working through various aspects of the study. Currently, we are writing up the report.
The study fell into two areas:
Phase I — understanding what had happened in those very early days in Wuhan, and how that might be a guide to the origins.
Phase II — after receiving that information, working out what studies needed to be done to extend the information around finding the origin of COVID-19 disease, now known to be caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus 2 [commonly called coronavirus]).
The team had three areas of expertise. One was around animals and the environment; another was around the sequences of the virus in its early days; and the third group was focused on understanding the spread of disease in humans in those first few weeks.
Which professionals and civilians did you meet with to discuss SARS-CoV-2 in China?
The group we met fell into those various categories mentioned above: Epidemiologists from China’s CDC (Centre for Disease and Control) and from Hubei and Wuhan’s CDC. We also met with the people who did the sequencing of the virus in some of the universities and viral genetic laboratories.
Then we met a range of people involved in animal studies. That included people from the various ministries in China working in agricultural and animal health.
We also met with some of the doctors at the hospitals that were involved in the early outbreak and also some patients who were affected very early in the outbreak, to get an understanding of the impact of this disease on individuals and also the community.
What was the interaction like between the representatives of the various countries on the investigating team? Was there a consensus of how to proceed? Were there disagreements?
Yes, there were differences of opinions and scientific arguments and so on, over the data between both sides — the Chinese and WHO — but I think there was a respectful and open process for working through those arguments. I think it was actually good.
The U.S. Centers for Disease Control and Prevention tested blood donated to the Red Cross and found that the disease had probably reached America as early as December 13, 2019. The Chinese had stored blood donor samples in Wuhan from 2019. Why do you think the Chinese did not allow you to test their donor stored blood samples?
We certainly had a meeting with the Wuhan Blood Center that is responsible for blood donations in Wuhan, where there are 11 million people. They had done some studies during the outbreak on how much SARS-CoV-2 there was in the blood donating population which was broadly a representative of the community.
All blood donations services store blood for a couple of years to make sure that you have something to go back and investigate if there is a problem with a blood transfusion. So the Wuhan Blood Centre has that material and they are investigating going back and doing that testing on material that’s from before December 2019. The process of doing that work is underway. There are, of course, legal and ethical issues that have to be addressed, as with any study, which is underway.
There is a theory that the disease leaked from a lab in China. Did you investigate that lab? If so, what did you find?
Yes, there has been a discussion and ideas around a leak from a lab. Leaks from labs have occurred in many countries, e.g., Singapore, China, USA, Russia and the U.K. Fortunately, they are rare and they usually occur … when laboratories are growing large amounts of virus for particular purposes. It is rare that they occur from a clinical sample, e.g., nose swab or blood test.
We visited a number of laboratories including the Wuhan Institute of Virology. That one is being talked about because it is a well-known center for research into viruses.
We spoke to staff about their biosecurity protocols, what sort of methods they had for assessing staff health, including going back and testing blood samples. So people who work in high level viral security laboratories will often have, by regulation, blood collected each year, so they can always go back and test them. Those samples have been tested but they didn’t find anything positive.
We also spoke to the scientists doing the work around bat viruses in particular and, again, they have viruses that are reasonably close genetically to SARS-CoV-2, but not close enough to be the cause.
The important thing is that those viruses that are closely related, e.g., a virus called RaTG13 (which infects bats), is actually only a genetic sequence that hasn’t been cultured. With all those factors, it was pretty unlikely that it was a laboratory leak. Not to say that it is completely excluded as an idea should evidence come forward.
Another theory about COVID-19 is that the virus started elsewhere and arrived in Wuhan in the packaging of frozen imported food products. Did the mission investigate that claim?
Yes, we did have discussions about that but there have been a couple of outbreaks that have occurred in China. Last year, one occurred in a market in Beijing. Evidence of a virus was found on the outside of packages of frozen food and even occasionally on the inside of frozen food. We have some information that the virus may persist in that sort of environment for some time — those studies are incomplete and need to be done. It’s plausible for a localized outbreak to occur somewhere, e.g., in a fishery or abattoir, where the food is contaminated, turns up at another location and perhaps starts something off.
Based on what we know about viruses, I think it is unlikely that the cause of COVID-19 came from the contamination of food and packaging. In order for that to happen, food needs to be imported from a location where there is a big current outbreak. Additionally, the contaminated material would need to survive the process and transportation.
However, I think it is something that does need to be followed up and investigated. But we didn’t rate it as a high priority.
Local Chinese officials in Wuhan attempted to clamp down on information leaking out of the country in December 2019. Eight Chinese doctors expressed concern about the sickness but were reprimanded for spreading rumors.
A second cover-up occurred in January 2020, when the Chinese government, including President Xi Jinping, knew of human transmission in early January but did not say anything publicly. Yet he put the country into lockdown on January 23.
China has also misrepresented the number of deaths in their country.
Based on this information, do you feel China can be trusted regarding the information they are making available to you?
This mission was about trying to understand the origins of the virus and the origins of the outbreak. It actually wasn’t designed to investigate whether the responses by doctors, governments and countries were appropriate or not.
One could certainly argue that, in many countries around the world, the responses from public health and the government could be reviewed.
Do you feel they are concealing evidence from the WHO mission? If so, how does the mission hope to unveil the cover-ups?
By definition, we wouldn’t know if material was being hidden. I would point out that we were provided with a lot of information which has not been seen by WHO before. So I think perhaps material wasn’t always made available in the last year or so.
I think the sort of systems that you set up for disease surveillance, which are in place in China, e.g., influenza, are not designed to pick up something like SARS-CoV-2. So the system may not have picked things up.
I did feel that the scientists and doctors in China were just as keen as scientists and doctors anywhere to understand the causes.
The Chinese New Year fell on January 25, 2020. People flew in to China to celebrate the Chinese New Year on that day — when the virus was already being transmitted from human to human. Chinese medics and authorities knew that once the international Chinese travelers would return to their countries, they could be carriers of the disease and would accelerate the spread of the disease. Do you think China had a moral obligation to the world to have at least canceled the celebrations rather than having proceeded with them?
That is not something I would know about, to be honest, or have the expertise to judge.
It is reasonable to say, though, that in December 2019, when China started to report their first severe cases, they may not have appreciated the amount of spread of this virus by people who were otherwise well or very mildly symptomatic. In other words, there must have been lots of virus transmission going on in the community there that they didn’t realize.
Now we know, of course, that you can get a lot of spread by otherwise healthy or mildly symptomatic people. That may well be one of the explanations of why the virus spread so quickly to other places. As to whether they should have canceled the Chinese New Year, that is much more of a political decision than a scientific one.
Do you feel that the two members of the investigative committee who were on their way to China to investigate the pandemic and were denied entry because of a lack of visa clearance could also be a cover-up by China?
There were problems in trying to get to China initially and, unfortunately, a couple of people had already left but were stopped because visas weren’t issued. I am not quite sure why that occurred. But we were allowed to leave the following week. Whether that was deliberate or not, I’m not quite sure.
What was your conclusion from the trip to China?
I think there were a couple of conclusions. One thing we have to do is understand the impact of this disease on individual people, communities and cities, by meeting patients and doctors, etc., involved in the very beginning of this, which we estimated began in mid-November and early December 2019 in Wuhan. it must have been extremely difficult at the time. Even though we talk about data, numbers and cases, in the end these are people and we are dealing with lives. I think it is going to be like the 1918-1919 influenza pandemic. It is going to have a terrible impact on people and society for generations.
The second thing is that, with respect to the origins of the virus, obviously there isn’t an immediate answer. If it were easy, then it would have already been sorted out. We do know that with other diseases, like the Ebola virus in Africa, we have had outbreaks for approximately the past 40 years, yet it was only in the last few years that we’ve understood its origins.
Even with SARS back in 2003, it took well over a year or so to find and compare the facts. So I think there is more work to be done around understanding the various hypotheses around the origin, particularly the animals that might be involved like bats or other intermediate animals between bats and humans. I think that process clearly needs to happen so it will take time.
The third point is that it is important to understand the virus this time so that we can learn the lesson and manage it better the next time. There will always be another pandemic and they’ll vary in severity.
Will the WHO continue to investigate the origins of the virus, and for how long will these investigations continue?
Yes, the report, when it is released, will have recommendations about what sort of work needs to be done. Who does that work needs to be determined — the WHO or research organizations or epidemiologists. It is about identifying the nature of the beast and then having experts actually doing the work, getting the money to do it and getting the results. In that sense WHO could help facilitate [further work] with the report and the recommendation.
In your professional opinion, how did this all start?
I think the most likely way it started is that this virus was present in animal species, probably bats, because of all the other viruses that have come from bats. It has jumped from bats probably into some sort of intermediate animal (because humans and bats don’t have a close connection) that can carry the virus, that humans have contact with. I think that’s what’s happened with other viruses like SARS and MERS (Middle East Respiratory Syndrome) and indeed a fair few other viruses.
Would that have been through an animal that humans consume?
You would think so. There are animals that carry viruses. Transmission depends on the type of human contact you have with the animal. E.g., if you were a mink farmer and the mink gets the virus, then you pick it up directly from the minks and get infected. That is one thing we know that has happened. Or if you were farming animals or if there was other wildlife being used for meat, then the process of capturing and processing the wildlife into meat would be a risk factor. Even the meat itself being contaminated could be a risk factor as well. It depends on the nature of the interaction between man and animal that can lead to different types of spread of viruses.
The marketplace is where humans come in contact with animals and it depends on what types of animals are in the market and whether they are dead, alive, or frozen. So that is a very good opportunity for outbreaks of disease. We have seen outbreaks of all sorts of pathogens or viruses through open markets.
Do you think the fact that China is a Communist country played a role in how they handled the outbreak? If yes, how would a democracy have done it differently?
That is outside my area of expertise.
There are certainly some things that the Chinese did that were very successful in controlling the outbreak once it was going. The people in Wuhan were locked down for 76 days. Ultimately, that was successful. Whether everybody in other countries would accept that degree of control clearly varies.
To be honest, all countries, whether Communist or democratic, could have done some things better but did some things well.
What could have been done better?
Open local and international communications, sharing of information, technology, all of those things contribute to a better response and that is what we should be aiming to try and do.
We have agencies like the United Nations and the WHO that have that responsibility. So everyone should participate in that.
The other thing is ideally for countries to have a bipartisan approach politically to solve what is a public health problem. There’s nothing wrong with having different political opinions, but you want to try and put those aside for the betterment of everybody in your country and society. It is a tremendous strain on individuals, family groups, the country and the economy.
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