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Coronavirus

A Year Later, We Still Don’t Really Know Where COVID-19 Originated

China is a likely ground zero, but not certainly. Does it even matter?

Crawford Kilian 10 Dec 2020TheTyee.ca

Crawford Kilian blogs about COVID-19 here.

Any disease outbreak is as much a political and cultural event as a medical and scientific one. A pandemic is even more so, as COVID-19 has dramatically demonstrated for the past year.

Sometimes the political and medical become hopelessly tangled, and again this pandemic offers a good example: where and when did the SARS-CoV-2 virus emerge? Medically, finding the source of the virus could help prevent a recurrence. Politically, finding the country where it arose provides someone to blame.

China is probably the country of origin, but actually it doesn’t matter. Viruses jump to humans when they get the chance. Humans, meanwhile, jump to conclusions to please themselves.

So of course China (as the first victim of H7N9 bird flu, SARS and other outbreaks) was the usual suspect for the “pneumonia” first reported to the West on Dec. 31, 2019. The virus was even imagined to have escaped from a Wuhan lab, where it must have been weaponized. The Chinese in turn blamed it on an American-tailored version, released in Wuhan.

These schoolyard insults only showed how little we have progressed since the 16th century, when syphilis — probably imported by Columbus from the Americas — was the “French disease” to France’s neighbours. The 1918-19 pandemic was the “Spanish” flu only because Spain, as a non-combatant, could report it; the countries at war kept it censored.

The stigma associated with the origin of new diseases has led to a new way of naming them. What could have been “new Hong Kong flu” in 2002 was instead named Severe Acute Respiratory Syndrome, or SARS. The “novel coronavirus” is related to SARS, so this cousin was named on those terms: SARS-CoV-2. And the disease this virus caused was COVID-19: coronavirus disease, 2019.

It didn’t matter to Donald Trump, who keeps calling it the “China virus” and blaming the Chinese for exporting it to an innocent world. He seems to think that gets him off the hook for presiding over a preventable public health catastrophe that has so far cost his country at least 15 million cases and 290,000 deaths.

But the absence of an animal culprit at Wuhan’s ground zero remains a question. Some suspect a coverup: the local authorities closed and sanitized the seafood market, removing any evidence of a possible vector among the wild animals also on sale there. It doesn’t matter: other patients, without any contact with the seafood market, turned up as early as Dec. 1, well before the first cases linked to the market.

Early evidence outside China?

As the pandemic exploded across the planet, a few researchers looked for evidence of it even earlier, and not in China. One group found Italians with COVID-19 antibodies in samples taken in September 2019. An American study of blood donations found SARS-CoV-2 antibodies as early as Dec. 13, 2019.

Most dramatically, a PhD student in Spain published a pre-print claiming that the virus was in Barcelona sewage as early as March 2019. That report drew attention, but the pre-print doesn’t seem to have been accepted by a peer-reviewed journal, and the author did not respond to a Tyee inquiry.

Still, those cases were reported as evidence that COVID-19 had escaped from China far earlier than supposed — not that it had originated elsewhere. But that was only a supposition. Given the millions of people who travelled into and out of China in 2019, the virus might well have hopscotched around the world before doctors in Wuhan finally noticed it as something unusual.

That was the position taken by a Chinese team arguing recently that the virus’s mutation rate suggested it must have been circulating for at least four months before it came to notice in Wuhan.

A related pre-print by members of the same team claimed that the least mutated form of the virus, which must have preceded all others, was found in India and Bangladesh — as well as in Saudi Arabia and the Czech Republic. Again, the implication was that China had been the hapless victim of an imported virus. But while the pre-print was mentioned last month in a news report, it’s vanished from the pre-print library where it had appeared. (The PDF is still available.)

What’s most striking about the debate is that the Chinese thought it was worth joining. They seem to have accepted the premise of Trump’s “China virus” argument, that the first country to report cases of a new disease is somehow responsible for it.

The Chinese authorities in Wuhan certainly made serious mistakes in the early days of the outbreak, in December and early January. But so did almost all governments, including Canada’s.

The issue is really what governments learn from their experience, and how effectively they respond afterward. After a few weeks the Chinese locked down Wuhan and its surrounding province of Hubei. Less dramatically, Vietnam closed its schools and its borders and launched a rapid program of testing and tracing. New Zealand did something similar.

Such countries managed to escape the worst of the first wave and have been in a better position to deal with resurgences. Western nations tended to respond sluggishly and erratically, giving the virus a deadly advantage that it is still exploiting.

Countries like China and Vietnam still remembered the shock of outbreaks like H5N1, H7N9 and SARS, and were somewhat better prepared for COVID-19. New Zealand had the advantage of being an island nation that could seal itself off. Significantly, such countries also had excellent messaging; that made a major difference.

By contrast, Canada and the U.S. failed to shut themselves off quickly and thoroughly, and then tried to muddle through with contradictory messaging delivered by provincial, state and federal governments. Politicians’ anxiety about the economy has resulted in ineffective lockdowns, premature easing and health-care systems now coming close to collapse under the resurgence of cases. The economy is not benefiting from any of this.

Countries like China and Vietnam have deservedly poor reputations as repressive states, but their successes in pandemic control make them look good compared to countries where “freedom” looks like fecklessness, and “personal responsibility” means shrugging off political responsibility for hundreds of thousands of cases and deaths. Even so, it’s striking that China, for all its wealth and its medical high technology, still feels vulnerable to the stigma of having been ground zero for this pandemic.  [Tyee]

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