11.

Popsicle Origins and the World Health Organization

‘That which can be asserted without evidence, can be dismissed without evidence.’

CHRISTOPHER HITCHENS

On 30 January 2020, at a time when the Chinese government was silencing whistleblowers and ordering samples destroyed, the World Health Organization’s director general Dr Tedros Adhanom Ghebreyesus said China’s speed in detecting the virus and sharing information was ‘very impressive, and beyond words’, adding ‘so is China’s commitment to transparency and to supporting other countries’. Two weeks earlier, on 14 January, the WHO had even issued a tweet in line with China’s messaging insisting that human-to-human transmission was not happening: ‘Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China.’ Reinforcing the point the same day, 14 January, the acting head of the WHO’s emerging diseases unit, Dr Maria Van Kerkhove, announced that although there were clusters of cases in families, ‘it is very clear right now that we have no sustained human-to-human transmission’. Thus, at this stage the official WHO position was that the main way a person could catch this disease was if they came into close contact with an infected animal.

A WHO team visited Wuhan on 20 January 2020 to understand the response to the outbreak. They concluded that human-to-human transmission of the virus was likely, as the Chinese authorities confirmed that day, and obtained the design information of the diagnostic kit that the Chinese government was using to test for infection. ‘This follows China’s rapid identification of the virus and sharing of the genetic sequence,’ read the mission summary of the WHO field visit. ‘The delegation commended the commitment and capacity demonstrated by national, provincial, and Wuhan authorities and by hundreds of local health care workers and public health specialists.’

Behind the scenes, however, things were less friendly. WHO officials were complaining that information was not forthcoming. Dr Mike Ryan, executive director of the WHO Health Emergencies Programme, was secretly recorded as comparing the situation to the 2003 SARS outbreak: ‘This is exactly the same scenario, endlessly trying to get updates from China about what was going on in Guangdong.’ He added: ‘General “there has been no evidence of human-to-human transmission” is not good enough. This would not happen in Congo and did not happen in Congo and other places.’ The WHO did not confirm that these remarks had been made.

In February, Dr Lawrence Gostin of Georgetown University complained: ‘We were deceived.’ He elaborated to the Washington Post: ‘Myself and other public health experts, based on what the World Health Organization and China were saying, reassured the public that this was not serious, that we could bring this under control. We were giving a false sense of assurance.’ To the sharp surprise of many, the WHO decided, on the advice of an emergency committee, on 23 January not to declare an international emergency. This had followed intense lobbying by the Chinese government. China’s ambassador made it clear that an emergency declaration would be regarded as a vote of no confidence in the country’s handling of the outbreak. The decision was reversed on 30 January, with only the Chinese delegate voting against. A delegation from the WHO was sent to Beijing in mid-February. Three international experts went to Wuhan alongside three Chinese experts. They stayed for a day and visited two of the hospitals but did not visit the Huanan seafood market. ‘It was an absolute whitewash,’ said Dr Gostin to the New York Times. ‘But the answer was, that was the best they could negotiate with Xi Jinping.’

It was not until 11 March that the WHO declared a pandemic. Even after that, Dr Gauden Galea, the WHO representative in China, lamented publicly that his repeated requests that the WHO be allowed to observe the Chinese government’s investigations were being refused. ‘We know that some national investigation is happening but at this stage we have not been invited to join,’ he said. We attempted to contact Dr Galea in January 2021 but were told by the WHO that he was ‘on leave and not reachable’.

Terms of reference

During the spring and summer of 2020, the WHO negotiated with the Chinese government to be allowed to engage in a joint study. Dr Peter Ben Embarek, a Danish food scientist and WHO official, visited China in July for talks with various relevant agencies, but, according to later leaked documents, was dismayed to find that ‘little had been done in terms of epidemiological investigations around Wuhan since January 2020’.

Finally, in November 2020, the WHO released a ‘Terms of References for the China Part’ detailing its current understanding of the origin of the pandemic and setting out how it intended to follow up. The document was dated 31 July, so it had been in preparation for three months when released. It frankly conceded that the origin was still a mystery: ‘Little is currently known about how, where and when the virus started circulation in Wuhan. Preliminary studies have not generated credible leads to narrow the area of research, and studies will therefore focus on developing comprehensive study plans to help generate hypotheses on how the outbreak may have started in Wuhan.’ The document also conceded that there was still no evidence to support a natural origin hypothesis: ‘There is no evidence to demonstrate the possible route of transmission from a bat reservoir to human through one or several intermediary animal species.’ And it admitted that there was no evidence either for an origin within the food markets: ‘There is no evidence that contaminated food items may have contributed to transmission.’ It did not mention the possibility of a laboratory leak or steps that would be taken to gather information about the research that had been carried out on SARS-like viruses in Wuhan.

The final composition of the international team was to be agreed by both China and the WHO, with a list of candidates submitted to the Chinese authorities for approval. We would later learn that half of the team comprised scientists in China, and that all team documents had to be signed off by each member. One of the Chinese members was Dr Feng Zijian, the deputy director general of the Chinese CDC and the man who co-signed a gag order in February 2020 that was leaked to the Associated Press. Another was Dr Tong Yigang, a collaborator of Dr Daszak and the WIV in virus hunting, who was also a co-author on one of the pangolin papers. Dr Feng co-led the epidemiology subgroup, and Dr Tong and Dr Daszak led the animal and environment subgroup.

Dr David Relman of Stanford University, who raised the possibility early on that the virus might have leaked from a laboratory experiment, told us at the time: ‘Based on the scant information that has been shared publicly about the WHO investigation, it doesn’t appear that WHO has adequately represented the range of views and perspectives of key stakeholders or incorporated all needed forms of expertise. And it does not appear that the investigation will receive adequate, independent oversight and review. Needless to say, it doesn’t make sense to allow any one nation to dictate the terms of the investigation or dominate membership of the committee.’

Of particular concern was the presence on the WHO-convened team of Dr Peter Daszak, given his close collaboration with the WIV over several years and his having organised a statement in the Lancet in February 2020 to ‘condemn conspiracy theories suggesting that Covid-19 doesn’t have a natural origin’. That same month he wrote an opinion article in the New York Times claiming that the outbreak vindicated his prediction that a new pandemic ‘would likely result from a virus originating in animals and would emerge somewhere on the planet where economic development drives people and wildlife together’. In June 2020, Dr Daszak showed he had not changed his mind, writing an opinion piece for the Guardian headlined, ‘Ignore the Conspiracy Theories: Scientists Know Covid-19 Wasn’t Created in a Lab’. Neither the Guardian nor the New York Times noted his links with the WIV when they ran these articles, though the Guardian later added a note to ‘make clear the writer’s past work with researchers at the Wuhan Institute of Virology’. As a reminder of those links, in an email sent in early January 2020 to a contact at the NIH, later revealed under FOI requests, Dr Daszak had said: ‘I spent New Year’s Eve talking with our Chinese contacts . . . I’ve got more information but it’s all off the record.’

Dr Daszak’s inclusion in the WHO team brought strong criticism. ‘The independence of the WHO investigation may be seriously compromised by the process used to choose investigators,’ said Miles Pomper, one of the authors of a substantive guide to investigating outbreak origins, published in 2020 by the James Martin Center for Nonproliferation Studies. ‘In particular, the choice of Dr Daszak, who has a personal stake in ensuring current Chinese practices continue and who is a long-time collaborator of a scientist at the center of the investigation, is likely to taint its results.’ Later the journalist Nathan Robinson asked: ‘Why would the WHO retain an investigator who seems to have made up his mind about the pandemic’s origins before investigating them, and whose entire personal reputation rests on reaching one conclusion over another?’

The first phase of investigation, focused on the epidemiology of early cases, was to rely heavily on Chinese work to ‘build on existing information and augment, rather than duplicate, ongoing or existing efforts’. Chinese scientists would conduct all the primary research, including analysing sewage and blood donations, going back through hospital records and interviewing early patients. They would also map and trace the cases of people who visited the market and categorise the food on sale there. As the months passed, however, no information emerged about such investigations and by January 2021, when the WHO team was due to travel to China, it was still wholly in the dark about what had been learned.

By then the WHO team was due to be in Wuhan but its arrival had been delayed by the Chinese government, resulting in what Bloomberg called ‘a rare rebuke’ from the WHO on 5 January 2021. After some of the team had already set out for China, visas were unaccountably not issued so they had to return home. Dr Tedros, the WHO director general, said: ‘I am very disappointed in this news. I have once again made it clear that the mission is a priority for WHO and the international team. I have been assured that China is speeding up the internal procedure. We are eager to get the mission under way as soon as possible.’ The Chinese foreign ministry spokeswoman responded with ‘There might be some misunderstanding in this’ and ‘There’s no need to read too much into it.’

The press conference

Eventually, on 14 January, some but not all of the international scientists arrived in Wuhan, led by Dr Ben Embarek. They spent the first two weeks in quarantine in a hotel. Only then, for the first time, did the Chinese half of the team share the results of analysis they had done over the previous months. Only on 28 January did the team embark on twelve days of tightly controlled visits to relevant places in the city, going to hospitals, a museum with an exhibition celebrating China’s heroic efforts to defeat the pandemic, a food wholesaler, the seafood market, its cold storage, an animal health centre, the Center for Disease Control and the WIV. The team did not visit the Wuhan Central Hospital where the two most prominent doctor whistleblowers had been working: Dr Ai Fen and Dr Li Wenliang. They did visit the Jinyintan hospital where the severe cases were sent but were told that there had been no measures to sample from families of early cases or to store samples for longer than a week. When the Jinyintan staff were asked about the origins, they referred to early cases in other countries, imported food products and the cold chain. The team visited the closed Huanan seafood market and found no evidence of live mammals having been sold, though they did raise the fact that the virologist Dr Edward Holmes had taken a photograph seven years before showing a caged mammal at the market. Witnesses produced for the team said they had not seen any live mammals being sold, but there was no opportunity to question ordinary market workers or passers-by to resolve this contradiction. Even as the visit continued, the Chinese government played it down. It was ‘part of a global study, not an investigation,’ said a foreign ministry spokesman, Zhao Lijian, pointedly on 1 February.

On 9 February, the WHO-China Joint Mission on Coronavirus Disease held a press conference in Wuhan to announce its findings. It took close to three hours but answered only five questions. The team announced that the hypothesis that the virus arrived in Wuhan on frozen animal products or seafood was plausible and should be followed up, while the hypothesis that it leaked from a laboratory was so ‘extremely unlikely’ that it would not be pursued in the second phase of the study. In August, an interview of Dr Ben Embarek for Danish television would reveal that he had negotiated with his Chinese counterpart for the inclusion of the laboratory-leak theory in the China-WHO report; this inclusion was made on the condition that the report would not recommend any specific studies to follow up on the laboratory-leak hypothesis. Instead, more work had to be done to understand ‘the possible role of the cold chain frozen products in the introduction of the virus over a distance,’ said Dr Ben Embarek, adding that the virus ‘could have taken a very long and convoluted path involving also movements across borders, travels, etc. before arriving in the Huanan Market’.

In saying this, the WHO team appeared to brush aside the exoneration of the market announced the previous May by the Chinese CDC director. Dr Ben Embarek told Science magazine: ‘Some traders at the Huanan market were trading in farmed wild animals – badgers, bamboo rats, rabbits, crocodiles and many others. Several of these animals are known to be susceptible to SARS viruses. Some of them come from farms in provinces where coronaviruses have been isolated from bats: Guangdong, Guangxi, Yunnan. Potentially, some of these animals were infected at those farms and then brought the virus into the market.’ Interviewed on CNN, one of the members of the team, Dr Daszak, said: ‘There was a really striking piece of evidence that was mentioned today in the press conference that in those products were included wildlife meat and carcasses from animals that we know are susceptible to coronaviruses and also that the supply chains come from places in China where we know the SARS-coronavirus-2-related viruses are.’ In his opinion, this was ‘a direct link’ from the potential bat origins of the virus to the Wuhan market. Yet Dr Daszak conceded that all the frozen carcasses that were tested had proved negative for coronaviruses. This left some viewers and his CNN interviewer baffled as to quite what was so striking or what specific evidence supported the link with frozen products.

WHO-China origins of Covid-19 joint study news conference in Wuhan, 9 February 2021.

REUTERS/Aly Song/Alamy Stock Photo

It is worth thinking through this frozen-food theory, which Alina named the ‘Popsicle Origins’ hypothesis as a pun on the widely discussed ‘Proximal Origin’ paper. The WHO-convened experts and the Chinese government were asking us to believe that somewhere in southern China or Southeast Asia a ferret-badger or some other susceptible animal came into contact with a horseshoe bat, contracted a disease, was killed, butchered, frozen and shipped to a market many hundreds of miles away in Wuhan. Miraculously, the virus not only survived on or in the frozen meat for an extended period of time but proved capable of efficiently infecting people on arrival in Wuhan. Yet it caused no illness in people at the source, the local community, or other destinations supplied with these frozen products, though given what we know of viruses it would have been much more infectious at the start of its journey, before being frozen, than at the end. Despite never having infected a human being before, this rare virus, once in Wuhan, proved so well suited to infecting human beings as to be able to readily transmit from a popsicled animal to its first victim and then between people. Then, to cap it all, having achieved this feat once, the virus mysteriously vanished, leaving no trace in all other samples of meat in the same market or elsewhere in China. One international expert on the China-WHO team, Dr Fabian Leendertz from Germany, later told the New York Times that he thought the frozen-food hypothesis was a ‘very unlikely scenario’ but the team had agreed to include it ‘to respect, a bit, the findings’ of their Chinese counterparts.

As for the possibility of a laboratory leak, the total amount of time the WHO-convened team had spent at the WIV on 3 February was only two to three hours. The team was also walked through the BSL-4 laboratory at the WIV even though all the SARS research had been conducted at BSL-2 and -3. And they only visited the new Jiangxia campus, whereas at least until some time in 2019 most of the relevant laboratory work had been done at the old Wuchang campus, as shown by the address given in the relevant publications (see map here). Whether and when various work streams shifted to the new location has not been divulged, so it is not clear that the WHO investigators saw a laboratory that had been used by Dr Shi’s team at all. Dr Ben Embarek said that during their visit to the WIV they had ‘a very long, frank, open discussion with the management and the staff’. He also told reporters, apparently without irony, that WIV officials were ‘the best ones to dismiss the claims and provide answers to all the questions’. He later added in an interview with Science magazine, ‘We discussed: what did you do over the past year to dismiss this claim? What did you yourself develop in terms of argumentations? Did you do audits yourself? Did you look at your records? Did you test your staff?’ Also, said Dr Ben Embarek, they had looked at the BSL-4 laboratory and ‘it was very unlikely that anything could escape from such a place’. Which was revealing, because most of the work on SARS-like viruses happened in BSL-2 and BSL-3 laboratories, as someone seriously looking into the lab-leak hypothesis should have known. This approach of determining whether a laboratory leak had resulted in Covid-19 was so transparently naive that the host of 60 Minutes, Lesley Stahl, later called it out in an interview with Dr Daszak: ‘But you’re just taking their word for it.’ To which, Dr Daszak replied, ‘Well, what else can we do?’

Access to raw data

The WHO-convened team encountered a roadblock when they enquired about raw data, particularly those describing the first Covid-19 cases in Wuhan. ‘We did not collect any samples ourselves, we didn’t carry out any laboratory studies there, we just analysed what we were being shown,’ said one of the international experts on the team, Dr Vladimir Dedkov, an epidemiologist from the St Petersburg Pasteur Institute in Russia. The international half of the team only had access to what were largely summary reports from their Chinese counterparts, although the leader of the Chinese half of the team said that the international members could view the data and materials. ‘They showed us a couple of examples, but that’s not the same as doing all of them, which is standard epidemiological investigation,’ said another member of the team, Dr Dominic Dwyer, a microbiologist from Australia. It is notable that the report’s map of confirmed early cases in Wuhan, plotted by their home addresses, closely resembles the density of the elderly population in the city. However, the international team members were not shown raw data, making it difficult to tell if there were clusters in homes or retirement communities to explain the explosiveness of the outbreak in December 2019 in places with many elderly residents.

This lack of access meant that the analysis could not be independently reproduced by other experts. Later in 2021, the Washington Post reported several important errors in the China-WHO joint report relating to the early patients and clusters. Independent experts told the newspaper that it was imperative to find out how such mistakes of critical importance had been made, warning that these fed into public distrust of the China-WHO study. In response to questions about conflicting details in their report, the WHO clarified that the first family cluster of infections in Wuhan had no exposure to the Huanan seafood market. In addition, the map in the joint report depicted the earliest Covid-19 case as living (home address) on the north-west side of the Yangtze river where the Huanan seafood market was located. However, this conflicted with the Wuhan government’s account that the first patient who sickened on 8 December 2019 actually lived on the southeast side of the river and in the Wuchang district, where one of the WIV’s two campuses is based. (It is important for us to note here that, due to the lack of access to patient data, the dates of symptom onset for early cases are often difficult to verify.) The China-WHO report had detailed that this patient, an accountant by profession, had only visited one market: an RT-mart, which belongs to a chain of hypermarkets comparable to a Costco or Walmart, in other words, not a place where live wild animals would be sold. Furthermore, the RT-mart that the Wuchang accountant had visited was in the Jiangxia district, where the second WIV campus was located and even further away from the Huanan seafood market.

The WHO described these ‘unintended errors’ or ‘editing errors’ in their report as not being relevant to the origin of the virus because ‘the current first known patient is most probably not the first case’. However, by the time these errors had been identified, a group of prominent scientists had already attempted to extract the approximate home addresses of early patients, using Adobe Illustrator, from the low resolution map in the China-WHO report. Despite not being able to find an animal source of the virus at even a single market, the same scientists speculated that there could have been not one but multiple spillover events in Wuhan. Their multi-market hypothesis was based on the China-WHO report’s vague description of some of the early cases’ exposure to other Wuhan markets – which we now know includes supermarkets.

The China-WHO report also revealed the criteria by which early cases had been identified, which likely suffered from ascertainment bias. Specifically, exposure to the Huanan market was one of the key factors in determining whether a patient was a suspected case of Covid-19. Cases were marked as suspect if they were linked to ‘related markets in Wuhan’ and presented at least two clinical manifestations: fever, pulmonary imaging characteristic of pneumonia, reduction in white blood cell count or lymphocyte count, or no significant improvement in response to three days of antibiotic treatment. Eventually, these criteria were expanded to evaluate cases with links to other fever or respiratory disease patients or Covid-19 clusters. This means that the initial approach of identifying Covid-19 cases may have been biased towards those with links to the Huanan market and its cluster of cases, as well as the elderly who are concentrated in the area north-west of the Yangtze and are more likely to exhibit multiple clinical manifestations when infected by SARS-CoV-2.

As for early cases of illness in 2019 that might have later proved to be Covid-19, these were first selected by doctors in Wuhan, then evaluated by six Chinese experts, and the summary was presented to the international experts. The triaging of these suspected cases was stringent, requiring at least two non-mild symptoms such as fever and pneumonia – diagnostics were still in development and not widely used at the time – which may have led to the exclusion of real Covid-19 cases. The early criteria also focused on exposure to markets, but not laboratories. Out of a total of 76,253 episodes of illness retrospectively identified, only ninety-two were considered clinically compatible with Covid-19. Even so, further review deemed all these cases not to be SARS-CoV-2 infections and the patients were only followed up in January 2021. Unsurprisingly, more than a year post-illness, none of them were found to still carry SARS-CoV-2 antibodies.

Tantalisingly, Dr Marion Koopmans, a Dutch virologist on the team, told the Wall Street Journal that even the data they saw could possibly indicate infections as far back as September 2019. Dr Ben Embarek estimated that there had been most likely thousands of cases in Wuhan in December 2019. But, showing a remarkable lack of urgency, the Chinese scientists had only tested stored patient samples in January 2021, right before the WHO team arrived. The possibility of analysing Wuhan blood banks, with blood donated and stored since early 2019, for evidence of early undetected cases of infection was under negotiation, but the Chinese side cited issues with obtaining appropriate permissions to test the blood. In addition, no samples from adults exhibiting influenza-like illness in the last three weeks of December 2019 were available for testing. Samples from the first Covid-19 patients had also been discarded early in the outbreak for safety reasons. Dr Rasmus Nielsen of the University of Berkeley expressed surprise that this work of testing blood samples and contact tracing the first patients had not been done to find the origin of the virus. Without access to these samples and data, it was not possible for the team to determine when the virus had first started spreading in Wuhan, or who the earliest Covid-19 cases were. Another member of the team, Dr Thea Fischer, a Danish epidemiologist, told the Wall Street Journal: ‘I am a scientist and I trust data. I trust documented evidence based on data, I don’t just trust what anyone tells me.’

The China-WHO study did at least glean some new information about wildlife sampling. The leader of the Chinese half of the team detailed that sampling of bats in Hubei province had ‘failed to identify evidence of SARS-CoV-2-related viruses and sampling of wildlife in different places in China has so far failed to identify the presence of SARS-CoV-2’. Tens of thousands of animal samples from different species, wild or farmed, and from at least thirty-one provinces in China collected in 2019 and 2020, had all tested negative for SARS-CoV-2. Within hours, Dr Daszak was retweeting Chinese state-owned media: ‘Aside from China, global experts are looking at southeast Asia, including Cambodia for potential origins of [the] coronavirus.’ That his tweet might cause undue alarm in Cambodia did not seem to occur to him.

A unique and original dataset

To many scientists’ surprise, in June 2021, researchers published an original study of the wild animals sold in Wuhan’s markets before the pandemic (as we described in Chapter 5). This was information directly relevant to the search for the intermediate host of SARS-CoV-2, conscientiously collected between May 2017 and November 2019 by Chinese scientists. The Huanan seafood market was among the sites they had surveyed on a monthly basis. Contrary to what the international experts had been told, there were shops at Huanan that sold live mammals that could have been possible hosts of SARS-CoV-2 although no bats or pangolins had been observed at the Wuhan markets. Some of the traded animals, including Chinese bamboo rats, raccoon dogs and hog-badgers, were housed in stacked cages and poor conditions. There was little observed enforcement of the requirement for the animals to be quarantined, disease-free and have origin certificates. It appeared that, despite the absence of SARS-CoV-2-positive animal samples, the Huanan seafood market had indeed carried potential animal hosts.

Yet the world was only hearing about this vital information a year and a half post-outbreak. In response to this long-awaited information on the live animals sold in Wuhan, one of the China-WHO team members, Dr Koopmans from the Netherlands, remarked on Twitter that these data ‘would potentially have made a difference during our visit’. Adding that had they been provided with this information, ‘I think we would have dwelled less on frozen meat.’

We noticed that the authors of this unique study were international, spanning China, the UK and Canada. We reached out to understand why the study had been released so late and were taken aback to hear that the manuscript had initially been submitted to a scientific journal in the spring of 2020 but was rejected several months later after the editor found it hard to believe that there were not pangolins and bats sold in Wuhan markets. An author told us that, despite having been subjected to two rounds of review, the paper was ultimately deemed by the editors to be of insufficient general interest despite its implications for the origin of Covid-19. After submission to Scientific Reports on 21 October 2020, it took another seven months before it was accepted for publication. In our view, this seemed an extraordinary case of journal editors not perceiving the significance and urgency of reviewing and releasing the study’s findings to help the search for the origin of the worst pandemic in a century.

The authors elaborated to us that the seasons were the main factor determining the amount of wildlife sold at the markets. In the winter, including November 2019, it was the quiet season of the wildlife trade in the markets so not many animals, including those susceptible to SARS-CoV-2, were on sale. Contrary to speculations that a shortage in pork might have fuelled the wildlife trade in China in 2019, the authors told us that there had been no noticeable increase in the sale of wild animals in Wuhan. It also remains to be seen how many of these species could be capable of transmitting SARS-CoV-2 to humans. Based on the numbers provided by their study, only a handful of Covid-susceptible animal hosts were sold by Wuhan stalls on average each day. For instance, on average, only an estimated eleven civets were sold by all seventeen wet market stalls combined each month, and stall keepers did not store more animals in the market than they expected to sell. This description of the wildlife trade in Wuhan is hardly comparable to the roaring civet trade in southern China. Remember that ten thousand civets were killed in Guangdong restaurants, farms and markets following the connection of the first SARS virus to civets. Furthermore, the Wuhan wildlife trade paper was staunch in its claim that no pangolin or bat had been found among the animals for sale: ‘Our comprehensive survey data corroborates that pangolins are unlikely implicated as spillover hosts in the COVID-19 outbreak.’ If this information had been available to the world in February 2020, would so many people have been so quick to embrace the hypothesis of the pangolin as intermediate host or the idea that the novel virus had come from illegally sold wild animals at the Huanan market in the middle of the winter?

While this study languished behind the curtain of peer review, videos of Chinese people consuming bat soup circulated in the media; the pangolin papers were published; the media went full-pangolin; and the China-WHO team assembled, made their plans, visited Wuhan and delivered their final report.

Incredulity in the west

Reaction in the west to the WHO’s dismissal of the laboratory leak hypothesis and endorsement of the frozen-food hypothesis was highly sceptical. Not all went as far as Dr Bruno Canard, a virologist at France’s National Centre for Scientific Research, who said: ‘The WHO investigation is a masquerade. There are so many conflicts of interest and obfuscation . . . The WHO is committing credibility suicide.’ Or The Australian newspaper, which wrote: ‘It would be hard to view the report by World Health Organization investigators into the origins of COVID-19 as anything other than an outrageous whitewash that has found exactly what Beijing has been trying to get the world to believe about the start of the pandemic. The report’s barefaced conclusion that it is “extremely unlikely” the virus emerged from the Wuhan Institute of Virology, just because Chinese scientists say so, beggars belief.’ Even moderate voices were critical. Jamie Metzl, a senior fellow at the Atlantic Council and a WHO advisor, called the press conference ‘a low point’ for the organisation. And the US national security advisor, Jake Sullivan, said: ‘We have deep concerns about the way in which the early findings of the COVID-19 investigation were communicated and questions about the process used to reach them.’

In response to such widespread criticism, the WHO director general, Dr Tedros, changed course: ‘All hypotheses remain open and require further study.’ Dr Ben Embarek also rowed back: ‘Let me be clear on this: the fact that we assessed this hypothesis as extremely unlikely doesn’t mean it’s ruled out.’ He explained that ‘if you want to explore such a hypothesis further, you need a different mechanism. You need to do a formal audit, and that’s far beyond what our team is mandated to do or has the tools and capabilities to do’, adding: ‘I don’t think the press conference was a PR win for China.’ Dr Daszak went another way. He tweeted, ‘@JoeBiden has to look tough on China. Please don’t rely too much on US intel: increasingly disengaged under Trump & frankly wrong on many aspects. Happy to help WH w/ their quest to verify, but don’t forget it’s “TRUST” then “VERIFY”!’ He criticised the US government’s response to the WHO announcement: ‘I’m disappointed that a statement came out that might undermine the veracity of this work even before the report is released.’ He then proceeded to make numerous statements himself before the report was released, and even participated in a public Chatham House webinar with two other members of the China-WHO team on 10 March 2021 titled ‘Inside the WHO-China Mission’.

The Wuhan press conference and the interviews of the international experts on the China-WHO team only generated more questions. CNN reported that some scientists expressed disbelief, finding it implausible that Chinese scientists had not yet performed rudimentary investigative work to find the origins of the virus. This would have included more extensive contact tracing of the first known Covid-19 patient in Wuhan and checking the supply chains of traders at the Huanan seafood market. Dr Daszak told CNN that the Chinese scientists had not yet visited the farms in southern China that supplied the Huanan seafood market: ‘No one has been there to test the animals . . . the farms are now closed.’ A Wall Street Journal report corroborated this story, interviewing farmers in southern China who had bred or trapped wild animals, who said that their animals had been bought and killed by the Chinese government and their farms shut down in response to a government campaign. It remains unclear whether animal samples had been collected from these traders and farmers in 2019 or early 2020, and whether tests were run to determine if the virus might have been present in the supply chain to Wuhan markets. However, Dr Maureen Miller, an infectious disease epidemiologist at Columbia University, commented to CNN: ‘It’s implausible that this research has not been done. It’s not realistic, given they have world-class scientists there, and the technology invested in over the last twenty years. They are sophisticated, they understand transmission pathways, and have been working on them for years.’

Earlier, in December 2020, Dr Daniel Lucey of Georgetown University in Washington, had told the BBC that he was sure that China had already searched for the virus in human samples from hospitals and in animal populations because Chinese scientists had the capability, resources and motivation to identify the origins of the virus. ‘I think it’s quite possible it’s already been found,’ he said, ‘but then the question arises, why hasn’t it been disclosed?’ If they thought the Huanan seafood market was the source of a contaminated animal or frozen product, why had they not tracked these back to suppliers located in the likely spillover zone of SARS-like viruses? After the Wuhan press conference, Dr Lucey told the South China Morning Post that it was ‘frankly implausible’ that these tests had not been done one year after the outbreak: ‘My question is why would it not have been done? It was known to be necessary and it’s in China’s scientific interest, it’s in their public health interest and it’s in their national security interest.’

One concern, expressed by Alina in a tweet after the press conference, was that the handling of the investigation showed the world that a country could get a free pass if a virus escaped from one of its laboratories so long as it took care not to give outsiders access to records and data, but simply asserted that all was well. The lack of international pressure, indeed the degree to which westerners and the WHO were willing to overlook a lack of transparency, will have given governments where accidents might happen in future – or even those contemplating making bioweapons – a clear steer on how easy it is to deflect awkward questions.

Ready to deploy

Under mounting pressure from the media, the China-WHO team scrapped its plan to publish an interim report. This was announced on 4 March 2021 after an open letter calling for a ‘Full and Unrestricted International Forensic Investigation into the Origins of COVID-19’, signed by two dozen scientists and experts, had been circulated among journalists and shared with the WHO days before publication in the Wall Street Journal. The authors had been meeting once a month, thanks mainly to the efforts of scientists based in France. This ‘Paris group’ included some of the most passionate investigators of the origins of Covid-19: Francisco de Ribera, Dr Rossana Segreto and Dr Monali Rahalkar, who we have described in earlier chapters as some of the key sleuths who uncovered the true story behind RaTG13; Dr Richard Ebright of Rutgers University who had been sounding the alarm on a possible lab origin of SARS-CoV-2 since January 2020; Dr Bruno Canard and Dr Etienne Decroly, the French virologists who had been the first outside of China to publish the observation of the unique furin cleavage site in SARS-CoV-2; Dr Filippa Lentzos, a science and international security expert from King’s College London, who had been consistently publishing articles about the possibility of a lab leak since the early days of the pandemic; Dr Nikolai Petrovsky, an Australian professor of medicine and one of the first scientists to point out that SARS-CoV-2 was surprisingly well adapted to utilising human ACE2 as a receptor; and one of the authors of this book, Alina.

After the press conference in Wuhan, Jamie Metzl, a WHO advisor, had galvanised the group to write the letter. It pointed out that the China-WHO team did not have the mandate, the independence or the access to do a thorough investigation into all plausible origin hypotheses. It also expressed concern that the media had given the impression that there had been a thorough investigation and that the results represented the official position of the WHO. The Wall Street Journal, which published the letter, quoted China’s foreign ministry criticising the letter as ‘“old wine in new bottles” that assumed guilt and lacked scientific credibility’. The Global Times, a Chinese state organ, promptly quoted China’s foreign ministry spokesperson Wang Wenbin: ‘The scientists involved in the so-called open letter know very well whether the letter was advice on coronavirus origins based on scientific and professional attitude or presumption of guilt and politicisation.’

On 30 March 2021, the full report of the China-WHO joint study was released. It stressed that ‘the final report describes the methods and results as presented by the Chinese team’s researchers’. This time, Dr Tedros said: ‘The team also visited several laboratories in Wuhan and considered the possibility that the virus entered the human population as a result of a laboratory incident. However, I do not believe that this assessment was extensive enough. Further data and studies will be needed to reach more robust conclusions.’ He added that ‘although the team has concluded that a laboratory leak is the least likely hypothesis, this requires further investigation, potentially with additional missions involving specialist experts, which I am ready to deploy’.

Governments from around the world weighed in on the report. Those of Australia, Canada, Czechia, Denmark, Estonia, Israel, Japan, Latvia, Lithuania, Norway, the Republic of Korea, Slovenia, the United Kingdom and the United States issued a joint statement expressing ‘shared concerns’ over the study and arguing for ‘a swift, effective, transparent, science-based, and independent process’ for future outbreaks. The European Union published a separate statement demanding ‘further and timely access to all relevant locations and to all relevant human, animal and environmental data available’.

Needless to say, this did not please the Chinese government. An unidentified Chinese scientist on the China-WHO study team was reported by Chinese state media as accusing Dr Tedros of being ‘extremely irresponsible’ for pursuing the lab-leak theory and warned that the WHO would be responsible if these comments jeopardised future work on tracking the origins of Covid-19.

The Science letter

Dr Tedros’s remarks led Alina to contact Dr Jesse Bloom of the Fred Hutchinson Cancer Research Center in Washington State and Dr David Relman of Stanford University – both highly respected experts in their respective fields of virology and microbiology – to see if they agreed that a letter by top experts calling for a proper investigation of a possible lab leak was now warranted. They had previously expressed and heard similar concerns about the lack of a credible investigation into lab-origin hypotheses from other scientist colleagues. Within a week, the three had drafted a short statement in support of a rigorous and credible investigation into the origins of Covid-19, early co-authors had been recruited, and the letter sent to Science magazine. It was published on 14 May with eighteen authors hailing from the Howard Hughes Medical Institute, Fred Hutchinson Cancer Research Center, the Broad Institute of MIT and Harvard, Caltech and the universities of Harvard, Yale, Stanford, Berkeley, Arizona, Chicago, North Carolina, Toronto, Basel and Cambridge. The letter stated: ‘We must take hypotheses about both natural and laboratory spillovers seriously until we have sufficient data.’ It acknowledged that ‘at the beginning of the pandemic, it was Chinese doctors, scientists, journalists, and citizens who shared with the world crucial information about the spread of the virus – often at great personal cost’. It urged that the world now ‘show the same determination in promoting a dispassionate science-based discourse on this difficult but important issue’.

The editor-in-chief at Science wrote an accompanying blog post saying: ‘My opinion is that the zoonotic origin of COVID-19 is far more likely, but good science requires that the laboratory escape idea be rigorously investigated before being ruled out. China should allow for a dispassionate examination of the data and allow scientists to do what they are trained to do.’ To fresh eyes, the most surprising name on the letter was Dr Ralph Baric’s – not only the world’s leading SARS-like virus researcher, but also a collaborator with Dr Shi of the WIV. Dr Baric had told the People’s Pharmacy website in May 2020 that: ‘The main problems that the Institute of Virology has is that the outbreak occurred in close proximity to that Institute. That Institute has in essence the best collection of virologists in the world that have gone out and sought out, and isolated, and sampled bat species throughout Southeast Asia. So they have a very large collection of viruses in their laboratory. And so it’s – you know – proximity is a problem. It’s a problem.’ He told the Italian television programme Presa Diretta in mid-2020: ‘You can leave no trace that it was made in a laboratory . . . if you’re asking about intent or whether the virus existed beforehand, it would only be within the records of the institute of virology in Wuhan.’

In interviews after the Science letter was published, some of the signatories expressed concern that ‘science is not living up to what it can be’ (Dr Relman), that ‘in many questions of science, it turns out the right answer is we don’t know the right answer’ (Dr Bloom), that ‘it would be a troublesome precedent’ not to evaluate the possibility of laboratory escape rigorously (Dr Sarah Cobey of the University of Chicago), that the collecting of bat viruses creates an opening ‘for new viruses to get close to humans’ (Dr Michael Worobey at the University of Arizona), and that an investigation of plausible hypotheses was necessary considering that eighty thousand animal samples in China had been tested with no sign of the virus or its precursor (Dr Akiko Iwasaki of Yale University). Writing for MIT Technology Review, the journalist Rowan Jacobsen was able to solicit a rare response from Dr Shi, who said that the letter’s suspicions were misplaced and would damage the world’s ability to respond to pandemics. ‘It’s definitely not acceptable,’ Dr Shi said of the group’s call to see her lab’s records. ‘Who can provide an evidence that does not exist?’

The Science letter caught the attention of the media. Not only was there widespread coverage but the tone of much of the coverage had noticeably changed. The New York Times altered its description of the laboratory-leak theory in a tab heading of a previous online article from ‘debunked’ to ‘unproven’. The fact-checking site PolitiFact removed a claim of ‘debunked conspiracy theory’ about a television interview on a laboratory leak, explaining ‘that assertion is now more widely disputed’. Vox quietly changed a line on its website from ‘The emergence of the virus in the same city as China’s only level 4 biosafety lab, it turns out, is pure coincidence’ to ‘The emergence of the virus in the same city as China’s only level 4 biosafety lab, it turns out, appears to be pure coincidence.’ The Washington Post carried an editorial arguing that ‘if the laboratory leak theory is wrong, China could easily clarify the situation by being more open and transparent. Instead, it acts as if there is something to hide.’ Long articles by journalists Nathan Robinson in Current Affairs and Donald McNeil Jr in Medium both made the argument that the political left had been too quick to dismiss the possibility of a laboratory leak. ‘I have often warned that liberals and leftists should be careful not to assume conservatives are always wrong about facts,’ wrote Robinson, ‘because sometimes they aren’t.’ The idea had been ‘tarred by the fact that everyone backing it seemed to hate not just Democrats and the Chinese Communist Party, but even the Chinese themselves,’ wrote McNeil. ‘But now, 17 months later, China is persistently acting like a nation hiding something.’

The upshot of the WHO’s inquiry into the origin of the virus was therefore not to provide an answer, but to galvanise some of the world’s top scientists and journalists into reopening the question.