Sunday, January 23, 2022

Why using technology in finding the origins of Covid-19 matters for the next pandemic

It’s been more than two years since the global pandemic started, and the search for the origin of the virus continues. Scientists, government agencies and the World Health Organization as well as our own Wall Street Journal reporters-have tried to nail down whether the pandemic began when an animal transferred the virus to humans, or if it came out of a laboratory accident. But the hunt has been marred by secrecy and confusion. In this episode: why it’s so important to find answers, and what new monitoring systems are being developed to ease the identification of future viral outbreaks.

JANET BABIN: Back in 2012 in the mountains of rural Southwest China, six men went into a small abandoned copper mine to clean up bat guano. Or bat poop. Then they got sick, and three of them died. And doctors couldn’t figure out what they had, so they called in a world-renowned Chinese research centre to figure out what they died of. This is my colleague, Wall Street Journal Senior Writer, Betsy McKay.

BETSY MCKAY: Wuhan Institute of Virology has China’s most advanced labs, it’s renowned for studying coronaviruses.

JANET BABIN: Many of those coronaviruses come from Southwest China, where the mine was located. That region is a hotspot for coronaviruses in bats. Several years after the mine workers died, some scientists from the Institute wrote up a report on what they found. Turns out, they identified several coronaviruses in the mine, including one from the same family as the one that caused the first SARS epidemic in the early 2000s. It didn’t gain a whole lot of attention at the time. Then in late 2019, people started getting infected with COVID-19 caused by the SARS‑CoV‑2 virus. The first known cases broke out in Wuhan, China. That sparked increased global interest in the city, and in the Wuhan Institute of Virology. Then the Wuhan Institute of Virology researchers wrote another paper saying they’d found a virus that at the time, was the closest known relative of SARS‑CoV‑2. But critically, they didn’t mention that it came from the mine. And they gave it a different name from the one they’d used in that earlier paper. But even with the name change, scientists abroad spotted similarities in viral sequencing data that suggested a link to the mine. And that intensified interest in the Wuhan Institute of Virology, with some wondering why it hadn’t highlighted the connection and why it changed the virus’s name?

BETSY MCKAY: Lots of questions about this virus found in the mine and what it represented, and disclosure from the scientists wasn’t great about that.

JANET BABIN: The Wuhan Institute scientists say the name was changed to reflect the name of the bat, the place and the year that it was found. With the pandemic surging, the abandoned mine and what was found in it started to get a lot of attention. Global health agencies wanted to check it out. Journalists wanted to talk to local residents. Chinese authorities set up roadblocks. My colleague, Jeremy Page has been covering China for the journal for a decade. And he found a way to get there.

JEREMY PAGE: I sort of drove around, past the point where the roadblock was. And instead of approaching the roadblock, I took a long detour up to a point sort of higher in the mountains.

JANET BABIN: Then he hopped on his mountain bike.

JEREMY PAGE: Loaded up with a lot of water and some food and other provisions, and then it was a sort of five to six-hour ride down. And mostly downhill, unfortunately, quite a lot of uphill as well. It’s a very, very mountainous area.

JANET BABIN: After he arrived in the rural village, Jeremy talked with some residents and was able to find the old mine. He found no scientific field stations there or other evidence that Chinese authorities were testing locals, even though that’s what global health authorities were recommending.

JEREMY PAGE: By the time I got there, it was near dusk. So, I only had a limited amount of time to explore. There wasn’t a whole lot to see there, it had been abandoned for so long and it was so overgrown.

JANET BABIN: Many scientists have since concluded that none of the viruses from the mine is close enough to the COVID-19 one to have been its source. Even so, this episode highlights the confusion and lack of transparency that would permeate the entire search for the origins of the global pandemic. From the Wall Street Journal, this is The Future of Everything. I’m Janet Babin. Today on the podcast, we review the international search for how the pandemic started. With reporters, Jeremy Page, Betsy McKay, and Amy Dockser Marcus, who investigated this story for more than a year. What went wrong? Will the question of how and where COVID-19 began ever be settled? What needs to happen differently in the future to more quickly identify, contain, and even prevent future pandemics? In the search for the origin of COVID-19, there were two big now well-known theories that investigators delved into immediately. The first is that the virus jumped from animals to humans. That’s because most of the first known cases of COVID-19 were found in the vicinity of the Huanan Market in Wuhan. That’s a place where live animals were sold for food. Again, here’s reporter Betsy McKay.

BETSY MCKAY: Many virologists do believe that the likelihood is greater than this virus that caused the pandemic to emerge into humans from an animal, naturally. In the wildlife trade, on a wildlife farm, something of that nature. And the reason is, is there’s a pattern of this happening. I mean viruses, more viruses are emerging and jumping to humans. So it would not be a surprise, at all.

JANET BABIN: Then there is the lab leak theory, that something went wrong at the Wuhan Institute of Virology. Which as we said, specializes in studying coronaviruses.

BETSY MCKAY: Everybody in fact in the beginning was asking the question, could this have come from a laboratory? Because there are a couple of very advanced laboratories in Wuhan, China that study bat coronaviruses.

JANET BABIN: This idea was quickly popularized by then President Donald Trump and Secretary of State, Mike Pompeo in early 2020.

REPORTER: Have you seen anything at this point that gives you a high degree of confidence that the Wuhan Institute of Virology was the origin of this virus?

DONALD TRUMP: Yes, I have. Yes, I have.

REPORTER: What gives you a high degree of confidence that this originated from the Wuhan Institute of Virology?

DONALD TRUMP: I can’t tell you that, I’m not allowed to tell you that.

JANET BABIN: To be clear, no US intelligence agency reports have been made public so far that can confirm any of these allegations.

BETSY MCKAY: There isn’t any evidence, there isn’t any smoking gun that says this came from a lab or this could have come from a lab. The evidence really is what everybody started with, which is, these labs happen to be in Wuhan.

JANET BABIN: China has repeatedly denied that the virus that causes COVID-19 escaped from one of its labs, but the whole issue only added to political tensions surrounding the search for the virus’s origin. While the pandemic continued to spread, China was pushed into a defensive position long before the investigation could get started. It wound up taking a full year for the World Health Organization to gain approval from the Chinese Government for an international team of experts, virologists, zoologists, and epidemiologists to go to Wuhan to investigate. And this delay meant researchers were fighting against time to find the source of the virus, but China says it provided timely access and cooperated fully with the WHO. The WHO-led investigators who finally reached Wuhan in January of 2021 were trying to find out how the virus got into humans. A likely hypothesis seen with prior coronaviruses was that a bat was living with the pathogen and it got transferred to another host animal. And from that animal, made its way into people. In just the last 20 years, there is evidence that bat coronaviruses caused viral outbreaks in people three times. So, the WHO-led team started looking for this host anima. A good place to start that search was the Huanan Market in Wuhan where many of the early COVID-19 cases were confirmed, and again, where those live animals were being sold.

BETSY MCKAY: They were kept in crowded conditions, caged, butchered on-site. And these are conditions in which viruses are known to spread. It can jump from animals to humans, it can infect humans.

JANET BABIN: But by the time the WHO-led investigators landed in Wuhan, again, more than a year after the first cases were identified, most of the animals on farms that supplied that market had been sold or killed as part of a Chinese public health effort to stop the spread of the virus.

ROBERT GARRY: You have to remember that early during an outbreak, things are pretty chaotic. They were seeing all these patients coming in from that market.

JANET BABIN: This is Dr Robert Garry, a Professor of Microbiology & Immunology at Tulane Medical School. He’s also the co-author of the research from early in the pandemic, it hypothesized that the virus was transferred to humans from an animal.

ROBERT GARRY: There were, knew they had animals there. And it was not an illogical conclusion that “Hey, there’s a lot of animal-to-human transmission going on.”

JANET BABIN: And Garry doesn’t fault Chinese authorities for destroying the animals in the market, even though some of the evidence that could have helped to reveal COVID-19’s origins was likely destroyed along with them. By the time the WHO-led investigators got there, they couldn’t find any trace of the virus in animal samples taken from the market. The WHO-led team also visited the Wuhan Institute of Virology, but they were forced to be fairly hands-off. Here’s our colleague, Jeremy Page again.

JEREMY PAGE: And they could ask a few questions, but they couldn’t examine any of the raw data or see sort of samples. And do the kind of forensic examination that many scientists believe would be necessary to really establish if it could’ve come from a lab, or at least to rule that out.

JANET BABIN: The WHO-led experts especially wanted to access blood samples from a Wuhan blood bank, from people who had experienced pneumonia-like illnesses in the fall of 2019, to see if there were early cases of COVID-19. But they were not given access to them. This lack of transparency from the Chinese Government fueled public speculation that China was hiding something. Or worst case, that may be the pandemic was the result of a lab experiment gone wrong.

JEREMY PAGE: I think it really highlights the question at the heart of this debate. And that is, does China’s behaviour simply reflect the instinctive opacity of its political system? Or, is there specific information that it doesn’t want to share with the outside world?

JANET BABIN: The WHO-led investigators expressed frustration over the lack of access to original lab reports and blood samples they received during their near four-week stay in the country. Chinese authorities say they shared large amounts of information, including some raw data with the WHO-led team. But that some data could not be copied or taken out of the country, because of privacy concerns. After its trip, the WHO-led team looked at everything it had collected and voted in a show of hands on what seemed like the most likely origin of the pandemic.

JEREMY PAGE: And crucially at the end of that trip, the WHO-led team concluded that a lab leak was extremely unlikely. And many other people in their scientific community, or at least a significant number of other scientists felt that was going too far. Or at least they hadn’t had sufficient access to draw such a clear conclusion.

JANET BABIN: Because of a lack of evidence, many in the broader scientific community called for a deeper investigation into both the natural origin hypothesis and the lab leak theory.

JEREMY PAGE: So after that, then opinions started to shift again in the scientific community. Because various individuals, first privately and then increasingly publicly began to say, “Hang on, they really should have been able to look into that a bit more closely.”

JANET BABIN: US intelligence agencies were also unable to say for sure how the virus originated, partly due to a lack of data from China. The agencies released an unclassified report of their assessment in August 2021, concluding only that the virus was not developed as a biological weapon and the Chinese authorities likely had no foreknowledge of the virus before the first known cases emerged. Coming up, why do researchers say finding the origin is so important? It’s been two years since the pandemic started. There are variants like Delta, now Omicron surging, and experts anticipate there will likely be more coming. But there are also vaccines and treatments, including at-home pills in the works. I asked Professor Garry at Tulane Medical School, why finding the origin virus still mattered?

ROBERT GARRY: What you do want to look at it, are these early cases and see where the cases are clustered.

JANET BABIN: Garry says this is essentially Epidemiology 101. To explain, he tells me the story of a nasty cholera outbreak that happened in a neighbourhood in London back in 1854. People were getting really sick. At the time, most people thought the disease was being transmitted through particles in the air. But a physician, now known as the father of epidemiology, figured out what was really going on.

ROBERT GARRY: His name is John Snow, nothing to do with the Game of Thrones.

JANET BABIN: Dr Snow talked to family members of people who had gotten sick, he searched for something all the victims had in common. He drew up a now-famous map of the neighbourhood and plotted each case. And that’s when he realized, they all drew water from the same local well. Snow hypothesized that the cholera was coming not from the air, but from the contaminated water.

ROBERT GARRY: The cases were all just around that pump, John Snow triangulated to where that pump was at. And looked at it, found cholera there and said, “Look, this is what’s causing the outbreak.”

JANET BABIN: Snow convinced the town officials to remove the well’s pump handle and prevented more people from getting sick by drinking from that well. And not all virologists agree, but Professor Garry says that the now-infamous animal market in Wuhan, China could be considered the modern-day equivalent of the London pump handle.

ROBERT GARRY: A lot of those early cases are within a one square mile area around the non-seafood market. It’s very striking.

JANET BABIN: Some of these methods like contact tracing are still done today, except with phone calls and apps. But researchers these days also use more sophisticated techniques to pinpoint viral outbreaks. One way to do this is to scrutinize a community’s blood supply, from all available sources, to see if a population has antibodies that indicate it was exposed to a specific virus. And researchers want to do this in Wuhan, to review China’s blood bank donations from before the outbreak was recognized. A World Health Organization-led team is also interested in any samples that exist from residents of Wuhan who live around that Huanan market. My colleague reporter, Amy Dockser Marcus has been covering the origins of the pandemic.

AMY DOCKER MARCUS: Blood donations can be a source for figuring out where viruses come from because scientists can study them. They can try to track where the people were when they first got infected when their first signs of illness came. They can study the samples to see the level of antibodies that may exist, and they can get a lot of information out of them.

JANET BABIN: Blood bank data could help us understand how long the virus has been circulating and pinpoint where it originated. But time to do that in China may be running out. Frozen blood supplies can degrade after a couple of years, and older samples are often cleared to make way for new blood. The main blood bank in Wuhan told the World Health Organization-led team it would keep samples longer than two years, but it’s unclear if others in China will do the same. Amy says much remains unknown about these blood samples, including whether they’ve been tested already and if the data is not being shared.

AMY DOCKER MARCUS: So there have been some papers that we have covered during our ongoing look at the origin of the virus, that argue that the window is rapidly closing in order to test biological samples that were taken early in the pandemic. And to use that information, to help try to unravel how the outbreak initially occurred.

JANET BABIN: Some researchers are advocating for the world to take a more proactive approach to blood testing and monitoring. So that future diseases and outbreaks can be discovered, and ideally slowed, before they go global.

MICHAEL MINA: We can use the information that’s stored in people’s immunological memory.

JANET BABIN: Until November 2021, Dr Michael Mina was a Professor at Harvard School of Public Health and Medical School. He’s now the Chief Science Officer of a biotech software company, eMed. Its platform enables at-home diagnostic testing services. Mina says that blood acts as a sort of immune memory system. Holding antibodies that point toward all the diseases a person has had in their lifetime, even if they’re not sick at the moment.

MICHAEL MINA: If we can unlock those memories, we can start to identify what it is people have been infected with and how recently even. And we can start to be able to use that as a very crucial tool to start building the data repositories we need to understand, how do different viruses transmit? How quickly do they move, what are the rules of how viruses move around?

JANET BABIN: Dr Mina says you can detect and profile these antibodies even years later, even if you don’t know the virus you’re looking for. He says he could set up a profile using just a or two of blood or saliva.

MICHAEL MINA: I could put that drop into essentially a little tube. I could profile it and get a readout of hundreds of thousands of different antibodies you may have, against all pathogens you could have ever been exposed to.

JANET BABIN: Dr Mina and his colleagues want to create a so-called global immunological observatory, basically an early monitoring system of the antibodies showing up in people’s blood around the world. Mina says epidemiologists could track existing and emerging diseases around the world this way, and then share the information with the public. Just like meteorologists take weather data from monitors around the world, and use it to predict weather patterns that we can easily access.

MICHAEL MINA: I would like us at some point to be able to open up our phones and ask the question, is there a lot of rhinovirus going around my community today? Is flu happening in my community? Is my child who is sniffling today most likely sniffling because of flu, and I shouldn’t bring them to see grandma? Or is my child sniffling because of adenovirus infection and maybe still shouldn’t bring them to see grandma, but the consequences are quite a bit lower?

JANET BABIN: To do this, they would need to learn to accurately decode these immune memories in blood. And that’s still in development. Through a pilot program, Mina and his colleagues have been building better technologies to be able to detect and profile disease antibodies. Again, even years later. There’s another reason search technique that helps virologists understand what disease could do, long before an outbreak happens. It’s called the gain of function research, and there’s a lot of back and forth over what even qualifies as this type of research. But many scientists consider it essential to limiting future outbreaks. During gain of function research, virologists take a pathogen. And in the lab, they give that pathogen a new property or function. And this is used to try to figure out how a virus might evolve in the future, to create potential vaccines or therapies. It’s also used to test whether a virus could become more transmissible if it undergoes certain genetic changes. This is done in the hopes of keeping a step or two ahead of the virus and predicting what variations it is likely to take next. Amy Dockser Marcus says there is a point at which this research turns especially controversial.

AMY DOCKER MARCUS: Once you have a pathogen that can cause disease in people, that’s a whole other issue. And it’s something that scientists worry about. Because on the one hand, they want to study these pathogens. They need to understand it. You need to know who your enemy is. And so, that’s why it’s so essential to study. On the other hand, there are scientists who say, “Yes, this is a very important area of research. But these pathogens are so potentially dangerous that why do we want to take a risk and enhance their ability to infect people, just to answer some questions that we might be able to find answers to in a less risky way?”

JANET BABIN: Amy says the White House may get involved in the issue.

AMY DOCKER MARCUS: The Biden Administration has signalled that they want to give new scrutiny to this, they want national security officials more engaged in thinking about the biosafety implications of working with these pathogens in labs.

JANET BABIN: Urbanization, deforestation, more meat consumption and climate change, experts say are all increasing the potential for viruses to spill over from animals to humans. Professor Garry at Tulane says scientists need all the tools they can to prepare for the future.

ROBERT GARRY: So the question is among the hundreds of thousands of viruses and animals, which ones are the threats to humans? And we can figure out some of this using tools like gain of function research.

JANET BABIN: New research standards would ultimately need buy-in from governments and scientists, same for that proposed global immunological blood surveillance system. Getting global consensus is now more difficult with geopolitical tension so high and nations exhausted from fighting the pandemic. Up next, why despite all we’ve been through during COVID-19, society may actually be less prepared for the next inevitable pandemic. We reported at the beginning of this year about all the ways the pandemic sparked scientific collaboration. Researchers with diverse backgrounds came together in unprecedented ways to battle a common enemy, the virus. Our colleague, Betsy McKay, says that the multidisciplinary approach was working and is vital to the study of dangerous pathogens.

BETSY MCKAY: These teams at the Wuhan Institute of Virology worked with Americans, they worked with scientists elsewhere in Asia. Because everybody brought something to the table in this network, everybody had a different area of expertise. If that network is blown apart, everybody loses.

JANET BABIN: That network is supposed to be fostered by the World Health Organization. It can guide nations that lacks strong, early monitoring systems on how best to track viral hotspots. It can offer a consensus on how best to share information on emerging diseases, and the agency can coordinate responses to outbreaks and set global standards for treatment. But some say its track record is wobbly. Lawrence Gostin is a Professor of Global Health Law at Georgetown University. He’s also the director of the World Health Organization Collaborating Center on National and Global Health Law. Though in that role, he does not receive funding from the WHO.

LAWRENCE GOSTIN: I start by giving the World Health Organization high marks for setting a very important ethical tone.

JANET BABIN: But Gostin says it also made a number of crucial errors. It was slow to recommend masks or to recognize the aerosol spread of the virus. Most egregiously, Gostin says WHO echoed China’s early statements that there was no human-to-human transmission of the virus.

LAWRENCE GOSTIN: The WHO repeated those messages and even praised China’s transparency. But the evidence was overwhelming, that there was a SARS-like virus, that it should have been reported much earlier and more transparently.

JANET BABIN: The WHO’s own leadership team has admitted to some faults in its handling of the pandemic. But many say the organization has to do a lot with a little, the WHO’s annual budget this year is 5.8 billion. That’s about a third less than the 2021 fiscal budget of the US Centers for Disease Control and Prevention alone. And at the moment, WHO also lacks authority.

BETSY MCKAY: This entire search and the controversy over it has exposed the limitations of WHO. WHO can’t tell countries what to do, it can’t lead an investigation into the origin of a pandemic. It can’t just go in and say, “We’re here, we’re going to start looking around.”

JANET BABIN: The WHO normally meets in May.

WHA MEMBER STATE REPRESENTATIVE: It’s my pleasure to join you-

JANET BABIN: But this year, a Special Second Session of the World Health Assembly was held in late November.

WHA MEMBER STATE REPRESENTATIVE: For the opening of this Special Session of the World Health Assembly.

JANET BABIN: During the meeting-

WHA MEMBER STATE REPRESENTATIVE: This is only the second such Special Session in the history of the WHO-

JANET BABIN: the Member States agreed to form an intergovernmental negotiating body to draft a pandemic treaty. It would create new procedures during outbreaks, that could include independent verification of state reports. During COVID-19, that kind of rule might have provided the impetus for all nations to be more transparent from the start. If this rift among nations and the World Health Organization remains unresolved, some experts say nations are less likely to create innovative strategies to prevent outbreaks and we could all find ourselves at greater risk from the next inevitable pandemic. Stefanie Ilgenfritz is the Editorial Director of The Future of Everything, Leigh Kamping-Carder is Deputy Editor. This episode was reported by Betsy McKay, Amy Dockser Marcus and Jeremy Page, as part of their year-long investigation into the origins of the pandemic. Maddie Bender is our Fact Checker. Our Sound Designer is Sarah Gibble-Laska. Kaitlyn Nicholas is our Producer. Kateri Jochum is the Wall Street Journal’s Executive Producer of Audio. And I’m Janet Babin, thanks for listening.

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source https://www.jbklutse.com/technology-in-finding-the-origins-of-covid-19/

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