We’re Not Ready for the Next Pandemic

We’re learning the wrong lessons from the search for COVID-19’s origins.

May 24 2021, 11:42am

The author of this op-ed is a postdoctoral fellow at Yale Law School’s Paul Tsai China Center and a particle physicist.

The report was delayed, again. The cloud of doubt thickened with every passing day.

The World Health Organization’s mission to Wuhan in search for COVID-19’s origins had been mired in controversy since the beginning. The trip, a joint effort by international and Chinese scientists, did not start until a year into the pandemic. Media outlets cited complaints from members of the international team, who were frustrated over mounting political pressure and limited access to raw data. Plans to release a preliminary report in late February were scrapped at the last minute. The full report was delayed by multiple weeks. When it was finally released, on March 30, its assessment of where and how humans caught the novel coronavirus—directly or indirectly, with or without a “lab leak”—satisfied few observers.

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Tedros Adhanom Ghebreyesus, Director-General of the WHO, acknowledged the difficulties the team encountered in China and that the results were inconclusive. “Let me say clearly that as far as WHO is concerned all hypotheses remain on the table,” he said at the press briefing on the report. 

To many in the West, the stumbles the WHO investigation faced are a continuation of the Chinese authorities’ initial cover-up of the outbreak. In the words of the U.S. State Department, they are the latest manifestations of the Communist Party’s “deadly obsession with secrecy and control.” 

The Chinese government is rightfully criticized for its obstruction and manipulation in this process, but blaming every roadblock the investigation has faced on one country and its authoritarian politics would be missing the greater lesson.

As the WHO plans the second phase of this search, and U.S. officials, as well as other national governments, are drafting their recommendations to the organization, it is critically important to examine what went wrong, what has been misunderstood, and where the responsibilities lie. 

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This is a story with no single villain or master plot, only imperfect actors trapped in an unjust system. The morals are as much about Chinese politics as it is about international governance. When a common goal gives way to partisan interests, the truth is buried in the quicksand of prejudice, paranoia, and political opportunism. It has been a perilous, slippery path from the start.

The Wuhan Institute of Virology is under scrutiny for alleged links to the pandemic. Photo: Hector RETAMAL / AFP

In the popular imagination, the Chinese government operates from a panopticon: Every move is observed. Every order is dictated from the top down. The reality is much more complicated. 

While the party under Xi Jinping has tightened central control, power within the bureaucracy remains fragmented. A lack of transparency, rather than serving a uniform agenda, is often the result of conflicting interests. Recognizing this intricacy is the first step in addressing underlying issues, so the same mistakes are not repeated in the next pandemic.

When the state places social stability above the wellbeing of its people, the official reaction to any bad news is to limit public awareness and shun responsibility, which begins at the local level. Information can flow within the bureaucracy and be kept from the public. If the damage becomes too great to conceal, like that of a viral outbreak, the state concentrates its blame on lower-level individuals to protect the system. The instinct for self-preservation spurs further censorship and deception.

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The Chinese government’s initial response to COVID-19 reflects this complexity. In the last days of 2019, Ai Fen, an emergency room doctor in Wuhan, shared information about a mysterious new pneumonia with a colleague. Ai was reprimanded by administrators at her hospital for “rumor mongering.” Eight other doctors who forwarded her message, including the young ophthalmologist Li Wenliang, received a visit from local police. Li fell ill two weeks after and died of COVID-19.

On the day of Ai’s warning, the Wuhan Health Commission had issued an internal notice to all hospitals in the city to collect information on a “pneumonia of unknown etiology.” The following day, the National Health Commission sent its first team of experts to Wuhan and alerted the WHO. While the National Center for Disease Control had declared internally the second-highest level emergency response on January 6, 2020, and the highest level on January 15, it’s not authorized to inform the public. 

It was not until January 20, when the central government finally acknowledged human-to-human transmission and changed the novel coronavirus’s designation from “unknown disease” to “infectious disease,” that existing legal mechanisms for epidemic control and information sharing could be utilized. Three days after, Wuhan went under lockdown. 

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The National Health Commission shared the genetic information of SARS-CoV-2 with the WHO on January 11, six days after Zhang Yongzhen, a virologist in Shanghai, uploaded the sequence to a database in the U.S. The time-gap is understandably suspicious, but as several laboratories were tasked with sequencing the virus, extra time was also needed for verification. Petty office politics likely contributed to the delay, as different institutions vied for the same credit. 

In the months since the pandemic started, politicians and pundits in the West would point to the Chinese government’s many mistakes and delayed actions as proof of a grand conspiracy. A monolithic, sinister China makes for a convenient adversary in great power competition. Painting the country as uniquely evil absolves outsiders of the need for self-reflection, obscuring the fact that a cumbersome bureaucracy, coupled with narrow self-interest, makes fertile ground for secrecy anywhere.

The othering gaze also tainted perceptions of the virus’s origin. The connection of earlier cases to a seafood market invoked racist stereotypes of native eating habits as a source of disease. Western mistrust of technological advancements in China was projected on the Wuhan Institute of Virology (WIV), the country’s first Biosafety Level-4 (BSL-4) laboratory. With little concrete evidence, the competence and motivation of WIV staff were cast under the most ominous light. A 2018 U.S. State Department cable was widely cited as sounding the alarm about “real safety problems” at WIV. What the cable actually said was that the “state-of-the-art facility” had not been fully utilized due to bureaucratic inertia and a shortage of highly-trained staff. From Senate chambers to the White House, politicians with the biggest podiums started amplifying theories that the novel coronavirus was a Chinese invention.

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A pathogen can be natural in origin, stored at a research facility, and accidentally released into the public. Laboratory incidents have happened all over the world. While genomic analysis of SARS-CoV-2 has challenged the notion of an engineered virus, it does not exclude the possibility that a natural sample might have escaped from a laboratory. Sensational rhetoric and wild speculations poisoned the discourse, creating additional hurdles to an honest examination.

In an ideal world, Beijing could have helped dispel the rumors by embracing transparency. A thorough investigation would also benefit the Chinese public in preventing future outbreaks. However, in an increasingly jingoistic political climate, such actions could be seen as a sign of weakness, a concession to foreign powers. As tough lockdown measures had largely eliminated domestic spread of the virus, the Chinese government was eager to rewrite the narrative as one of effective governance and ultimate triumph. Citizen journalists who tried to expose wrongdoing were jailed. Doctors who died on the front lines were hailed as martyrs. Collective grief was turned into propaganda. 

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The serious work of Chinese scientists was compromised by their government, as officials and state-run tabloids started spinning their version of conspiracy theories. The virus might have originated in the U.S., they claimed. The two superpowers were locked in a mud match of words. Baseless accusations were thrown to score points in front of their domestic audiences.

As the election season was heating up in the U.S., to “make China pay” for the pandemic became a popular campaign slogan and subject of presidential debate. Republican lawmakers introduced a bill, which would allow American citizens and their government to sue the Chinese state for damages over COVID-19. Seen across the Pacific, the arrogant gestures were not about accountability but extortion, another attempt by a declining U.S. to constrain China’s rise. Origins of the novel coronavirus were no longer a matter of science or even of governance. A border had formed around relevant information. Guarding it carried the banner of national security.

Peter Ben Embarek, co-leader of the WHO mission. Photo: Christopher Black / World Health Organization / AFP

“Let this mission and let other missions be about the science, not about the politics,” said Mike Ryan, executive director of the WHO’s Health Emergencies Program. “We are looking for the answers here that may save us in future, not culprits and not people to blame. I’m sorry for being very direct about this but sometimes I get a sense that that is the drive.” 

The WHO’s press conference on January 11, 2021 focused on two topics, the distribution of COVID-19 vaccines and the commencement of the international team’s trip to Wuhan. 

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The mission had endured a slow and rocky start over the past year. The Chinese government was reluctant to allow external investigators. Geopolitical tensions strained the negotiations. The WHO tarnished its reputation through a series of missteps seen as appeasing Beijing.

After months of diplomatic efforts, the WHO and the Chinese government reached an agreement in the summer of 2020. The scope of the investigation would cover early case data, genetic analysis of the virus, as well as animal, environment, and food product surveys. An examination of the laboratories in Wuhan was not included. 

Another half a year would go by before the international team made their way to China, their arrival suffering a last-moment delay as the government imposed additional health measures on oversea visitors. The foreign experts spent the first half of their month-long mission in quarantine, video-conferencing with Chinese colleagues. For the remaining two weeks, Chinese authorities continued to use COVID-19 prevention as an excuse to monitor and limit the team’s activities. The international members were assigned to one section of the hotel and prohibited from having meals with their Chinese counterparts. 

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The word “investigation” conjures up images of iconic TV detectives, armed with fancy tools and a keen observation, swabbing samples and scanning surfaces in search for clues. What actually took place during the joint mission was much more similar to an academic workshop, where experts reviewed aggregated data and scrutinized each other’s findings. The schedule included field visits to hospitals, laboratories, and wet markets in Wuhan, as well as a propaganda exhibit on the Chinese government’s “decisive victory” against the disease. The team spent half a day, at most one workday, at each site, hardly enough time to familiarize with a new place, let alone conduct an independent investigation.

Testings and analyses by Chinese scientists did provide valuable input on the genesis and evolution of the outbreak. Among the 174 patients from December 2019, less than a third had exposure to the Huanan Seafood Market; about half had no contacts with wet markets in the city. Genetic sequencing of the earliest infections showed variations in the virus, suggesting that the pathogen had been circulating before initial detection. It’s therefore critical to examine earlier data of respiratory illnesses that may contain unidentified cases of COVID-19. 

Among the 76,253 records of fever, pneumonia, and related illnesses in Wuhan from October 1 to December 10, 2019, only 92 of them were considered “clinically compatible with SARS-CoV-2 infection” by Chinese health authorities. 67 samples were collected in January 2021. All tested negative for COVID-19 antibodies. Since over a year had passed, it’s possible that the antibodies had diminished below detectable levels. Given the common symptoms of COVID-19, the international team also questioned the criteria that yielded so few suspected cases.

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In an interview with Science, Peter Ben Embarek, co-leader of the mission, acknowledged that this particular study led to “the most” heated debate among the team. International members were frustrated over denied access to raw data, which hindered their ability to “move quickly forward with new analyses.” 

“The politics was always in the room with us on the other side of the table,” Ben Embarek said. “We had anywhere between 30 and 60 Chinese colleagues, and a large number of them were not scientists, not from the public health sector.”

Officially, there’re 17 scientists on the Chinese team, and 17 on the international team. At the press briefing for the report release, a correspondent from Lancet asked how the rankings within the teams were determined, and whether findings from individual members would be published. Ben Embarek responded that while the members had started with “very diverse views,” they were able to “reach this consensus.”

Unanimous approval has its place in bioethics to halt potentially risky research. Requiring a uniform agreement in an open investigation, from a diverse group of experts with different specialties, discounts the scientific strength of this mission. When each member may face varying degrees of political pressure due to nationality, country of residence, professional or personal relationships, the demand for consensus also extends individual vulnerability to the entire team and undermines the credibility of their findings. 

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The international team did not have the skills or the mandate to carry out a forensic examination of biomedical research facilities in Wuhan. Instead of studying direct evidence, they reached their conclusion on the laboratory leak theory primarily by asking questions and hearing arguments from the Chinese side, who maintained that strict safety protocols were observed and no staff infections were found. This is hardly convincing. No operation is perfect. A negative result for antibodies does not exclude the possibility of infection months before. 

It’s entirely plausible, considering the many potential pathways through the animal trade, that laboratories played no role in transmitting COVID-19, but dismissing the possibility without any investigation—and citing as the sole exculpatory evidence statements from those who may be at fault—only reinforces the perception of a cover-up. The public’s attention on the Wuhan Institute of Virology (WIV), the only BSL-4 laboratory, has also obscured the fact that many types of coronavirus research can be conducted at lower level facilities, several of which are in Wuhan. The closest known relative to SARS-CoV-2 was discovered by and stored at WIV, but with a 96.2% similarity, it’s not close enough, which usually means 99% or above, to be the progenitor to the virus that causes COVID-19.

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At the urging of their Chinese colleagues, the international team also considered the contested scenario that the virus was imported to China through the cold food chain. While the pathogen can stay viable for long periods of time in low temperatures, including on the surface of frozen products, it’s highly unlikely that there was contamination at factories outside China earlier in 2019 without wide-scale local circulation of the disease. Nevertheless, Chinese officials and propaganda outlets have seized onto the measure of scientific uncertainty in the report to bolster their claim that the initial infection happened elsewhere.  

Finding the source of a new virus often takes years. Some searches are inconclusive after decades of effort. Release of the joint report only marks the first stage of this endeavor. At the press briefing, a reporter from Xinhua, China’s state news agency, asked if the WHO has plans to “send a mission to countries or regions other than China for this study.”

“We cannot just go on speculation, but we need to follow the leads,” Ben Embarek said. “Of course, nobody wants to have an origin in your backyard,” he added later. “But we are, again, following the science.”

The WHO is planning the second phase of a search for COVID-19’s origins. Photo: STR / AFP

On the day of the report’s release, 27 world leaders issued a joint statement, calling for “a new international treaty for pandemic preparedness and response.” The signatories are the Director-General of the WHO, the President of the European Council, and 25 heads of state from five continents. The leaders of the United States and China were conspicuously missing.

Goals of the new treaty include “greatly enhancing international cooperation” to improve alert systems and data sharing, as well as research, production, and distribution of medical supplies. 

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While the International Health Regulations, revised after the 2003 SARS epidemic, obligates all members of the WHO to promptly notify the organization in case of a potential global health emergency, it does not specify the sharing of genetic data or viral samples. 

In December 2006, the Indonesian government refused to share the H5N1 bird flu sample with the WHO. Invoking the United Nations’s Convention on Biological Diversity (CBD), the state claimed ownership over viruses in its territory. The CBD, enacted in 1993 as an environmental conservation treaty, addresses centuries of exploitation by rich countries in the developing world. It recognizes sovereign right over natural resources within national borders. 

The convention was not designed to regulate pandemic response, but by using it to assert “viral sovereignty,” the Indonesian government made a similar argument: Pharmaceutical companies in the West have routinely used biological samples from the Global South to develop lucrative products; the source countries not only are denied a share of the profit, but often have to pay exorbitant prices for these vital medicines. When life itself can be patented and commodified, a dangerous pathogen becomes a valuable “genetic resource.” Withholding it may be the only leverage poorer countries have to negotiate fairer access to treatments and vaccines. 

In the absence of a clear international framework to govern the flow of public health data across borders and subsequent benefit sharing, the response is left to states and individual actors. Inequities in the global system and weaknesses in national governance are percolated in the process. In 2012, an Egyptian doctor working in Saudi Arabia was unable to determine the cause of illness in a patient, so he sent a sample to colleagues in the Netherlands. A new virus, later known as MERS, was discovered, and the researchers applied for a patent on its genetic sequence. 

The Saudi government, who had been less than forthcoming about the infections, denounced the doctor and the Dutch team for violating its sovereignty. During the Zika outbreak in 2016, the Brazilian government was criticized for its reluctance to share information. The country’s newly implemented biodiversity law also caused confusion and bureaucratic delays on how to send viral samples overseas. For years, well-funded foreign research teams have been flying to lesser-developed regions, including West Africa during the Ebola outbreak, collecting data and specimens, and taking the information back to their home countries without crediting or collaborating with local staff. The unjust practice, known as “parachute research,” further incentivizes governments and institutions to shield information from external parties. 

In 2017, a string of publications using Chinese genetic data led to a heated discussion in the country. The work was important, but Chinese scientists played only marginal roles. “I’m not a nationalist, but this type of research feels like someone else is digging my ancestor’s grave,” one scientist wrote on social media. Others worried about its implications for drug development.

The Chinese government stepped up its regulatory efforts. In the summer of 2019, the government issued new regulations on human genetic resources, placing strict criteria on cross-border data sharing. That fall, a draft of the country’s first comprehensive biosecurity law was announced

Beginning with epidemic response and ending on bioterrorism and bioweaponry, the bill reads ominously prescient in light of the storm that started mere weeks after its introduction. The draft went through two revisions in 2020. Taking in lessons from COVID-19, newer versions added details on surveillance and alert systems for infectious diseases, reporting obligations, and wildlife protection. Other updates include more stringent provisions for laboratory management and information sharing. The legislation was passed in October 2020 and enacted this April.

“The state holds sovereign authority over human genetic resources and biological resources in this country,” begins the chapter that lays out the rules on what can or cannot be provided to foreign entities and the approvals needed for the former. Written in tense, forceful language, the new law is a proclamation from an assertive government facing a hostile world.

Beijing has reasons to feel threatened. The day its biosecurity law took effect, the Strategic Competition Act of 2021 was introduced to the U.S. Senate. With overwhelming bipartisan support, the 281-page bill seeks to “address issues involving the People’s Republic of China,” from digital technology to disputes in the South China Sea. It also contains a section on the origins of COVID-19, demanding that the Director of National Intelligence report to Congress within 180 days on the “most likely source” of the virus, as well as research activities at the Wuhan Institute of Virology and associated facilities. 

While the U.S. government, as much as anyone else impacted by the pandemic, has a right to know where the virus came from, making it an intelligence operation against China, wrapped in the narrative of great power competition, only deepens the animosity between the two countries and erodes public trust in the international system. It is also hypocritical. For decades, the U.S. government has rejected international efforts to attach a monitoring mechanism to the Biological Weapons Convention. The proposed protocol would allow randomly selected on-site visits to improve transparency and increase confidence in compliance, but U.S. officials argue that such visits pose security risks to proprietary or classified information, especially if the inspections might involve foreign intelligence agents. 

The novel coronavirus originated in nature. It has no agenda, no morals or political belief. Its presence among our species is a result of human activity. It is an indictment on all of humanity that when confronted with a common threat, the immediate response from governments has been more artificial divisions to determine who deserves to live and who must die. In the eyes of a state, security is not about preserving life but sustaining power. People are sacrificed to secure the fragile pride of a flag. The future is bartered to fulfill capitalism’s endless demand for profit. Truth gives way to partisan motives. 

“At the end of the day, there are people at the end of all of this data, and I think we need to bear that in mind,” Dominic Dwyer, an Australian epidemiologist and member of the WHO mission, said at the press briefing. On the last field trip the team took in Wuhan, they visited the Jianxinyuan Community Center. The center serves over 20,000 people, many elderly or disabled. The team met with survivors of COVID-19 and those who lost loved ones. They heard about services provided by the government and volunteer efforts during the outbreak. Beneath the official narrative, there is a shared language of grief and awe, of resilience and survival. 

A crisis reveals the best and worst of humanity. A community can extend from the near and dear to reach the farthest realms. Our fates on this planet are bound in the same fabric. The history of this pandemic is still being written. What we do now will decide how the next one plays out.

Yangyang Cheng is a postdoctoral fellow at Yale Law School’s Paul Tsai China Center and a particle physicist. Follow her on Twitter.

Tagged:

china, worldnews, world coronavirus

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