The thorny question of the origin of SARS-CoV-2: Who wants to find out, and who does not?
Last summer, a person I know took a walk on a footpath through wine yards bordered by trees at nightfall in Switzerland, close to the village of Eclépens, roughly at coordinates 46.656791, 6.522571. At a place where the tree branches are quite low, he had three head-on collision with bats. In the third such event, the bat had to crawl up his face to take flight again from the top of his head. No one got hurt, neither him nor the bats, but if we analyze this encounter from a virological point of view, we immediately realize how important this kind of events are to understand the origin of the SARS-CoV-2 virus, responsible for the present COVID-19 outbreak.
The bat species suspected of being at the origin of the precursor of the SARS-CoV-2 virus belong to the Rhinolophus family. They mainly eat insects. At night, they find their way and their food (flying insects) through echolocation: they scream in the ultrasound range and from the echo sent back by obstacles and preys, they (generally) avoid bumping their heads and manage to catch delicious moths and other insects.
From the virological point of view, the fact that bats scream all the time is important, because by doing so, they emit the droplets which coronaviruses use to spread. In addition, bats also communicate with each other. When the three bats mentioned above realized that there was a danger of a collision with a human forehead, they probably screamed the equivalent of “out of my way!” followed by a series of expletives, which further increased the amount of droplets with high viral load. If these bats were infected with a virus able to jump to humans, this could have been the beginning of a devastating pandemic. Some experts believe that coronaviruses are transmitted among bats more through feces than through saliva droplets, but in the event of a violent collision as described above, this form of transmissions is equally plausible. Obviously, in this incident, no transmission happened. Or maybe it actually did. Who knows? Maybe this was the moment when SARS-CoV-2 first infected a human being? No, of course, this happened in Wuhan. Or maybe not, as we will see below.
Such encounters are not rare. I remember that a classmate in high school told us that she lived in a farmhouse with some bats roosting in the attic. When she went up to the attic, sometimes she had to duck because a frightened bat fled through the staircase and she was afraid that the bat could get caught in her hair. This actually happens occasionally, and some victims of such incidents will have to get their hair cut off in order to free the bat, which might also bite and scratch. And yes, here too, we are talking about Switzerland, not about an “exotic” Asian country.
How is it that for many months now, all the Western media tell us that you have to catch a bat and take it to a wet market so that a virus could jump from bats to humans? Despite not being an expert in bat lifestyle, I was well aware of the events above at the time when bats became notorious as the possible origin of the present deadly virus epidemic. In late February 2020, NPR reported (1) about an ongoing long term research project published in June 2020 (2) showing that such spillover events are very common between bats and villagers living in the same area for many different viruses. However, to my knowledge, this has remained the only media report about this phenomenon, despite it being crucial for understanding the origin of the SARS-CoV-2 virus.
Many researchers and virtually all media did not get the memo and still peddle the narrative that without hunting and capturing wild animals, spillover events cannot happen (3). The problem with this narrative is that those bat species which are captured and sold on markets in some countries in Asia and Africa and also occasionally in the United States (4) are the relatively large fruit-eating bats. Extensive search has not revealed one single mention of the very small insect-eating bats from the Rhinolophus family being hunted or captured for whatever reason. The body of these bats measures some 40–80mm (2–3'’) in length, which makes them much too small for human consumption. The narratives “This virus comes from a Chinese wet market”, or more generally “This virus jumping to humans is due to the Asian habit of capturing and selling wild animals”, have become some kind of founder myth of the COVID-19 crisis. The fact that this myth is not based on any solid evidence, and that it relies on a lack of distinction between two fundamentally different types of bats, should send some alarm bells ringing. The fact that this myth has led to a massive rise in anti-Chinese and anti-Asian racism and that nobody does anything against it is even more alarming.
Before the SARS outbreak in 2003, nobody actually knew that bats were carriers of coronaviruses. Since then, research (5) (6) (7) (8) (9) (10) has revealed that not only coronaviruses in general, but more specifically β-coronaviruses and even their subgenus sarbecovirus, to which both SARS and SARS-CoV-2 belong, are common among Rhinolophus bats not only in parts of Asia, but also in parts of Europe and of the Americas. On the other hand, most experts have moved away from the earlier hypothesis that pangolins could have played an active role in the emergence of the present epidemic (11).
So, if the virus could have jumped anywhere from bats or some other animals to humans, and if (as we will see below) this spillover event did probably not happen in Wuhan at the Huanan market, where does this virus come from? We don’t know yet. However, there are some clues as to where we should start our search. To make it short: anywhere in the world, with a focus on Asia (in particular southwest China and Southeast Asia), Europe (in particular southern Europe) and North and Central America.
Some research indicates that the virus strain which caused the outbreak at the Huanan market was already better adapted to human bodies than to any of the possible original or intermediate host animals (12). This gives us an indication about the time when we must look for some kind of precursor virus strains circulating among humans: at least several months before the first samples were taken in China from patients who got infected at the very beginning of December. Obviously, such a precursor, being less well adapted to human bodies, will spread relatively slowly and not have as devastating an impact as the present strains. Consistent research shows that the most recent know strains of SARS-CoV-2 replicate faster in human cells and spread faster human-to-human than the older ones (13) (14) (15) (16). We can therefore expect a relatively slow course of illness in the precursors we are looking for. Since coronaviruses among bats and humans mainly replicate in the upper and lower respiratory tract, we must look out for respiratory outbreaks where the cause remains unclear.
Finding the precursors of the SARS-CoV-2 virus among humans and animals will be an arduous task, but it is not impossible. Recently, researchers found enough genetic material of the Spanish Flu virus from 1918 preserved in permafrost in Siberia to rebuild the whole genome sequence. Finding the trace of a virus which emerged a few months or years ago should therefore be a child’s play. Provided that finding this origin is really a priority.
An early possible trace of the SARS-CoV-2 virus: Virginia/USA, July 2019
For an early but not lab-confirmed trace of the precursor of SARS-CoV-2 circulating among humans in July 2019, we have got several media reports, one from a Virginia-based local TV channel (17) followed by many others, including from the Washington Post (18) (19) and CNN (20). These reports, with the first one dating back to July 11 2019, mention a respiratory virus outbreak at a nursing home in Fairfax County, Virginia, USA. Among 263 residents of an assisted nursing building, latest figures stand at 63 residents ill, 18 hospitalized and three fatalities. 19 staff also fell ill. Symptoms were mainly cough, pneumonia and fever. Two factors can explain the numerous press reports: on one hand, the high number of infected people in such a short time surprised local health officials. On the other hand, despite numerous tests performed by the federal CDC, the cause of the outbreak still remains a mystery; it could not be traced back to any of the “usual suspects” for this kind of outbreaks like the flu, Legionnaires’ disease, etc.
A reader’s comment below the first Washington Post article is interesting, because it links the virus to what appears to be a broader outbreak in the local community:
There’s some really nasty lower respiratory stuff going around this area. I’ve had it for almost 2 1/2 week and when I went to my doc last week he said he’s been seeing folks with the same thing all that week. If anyone with a compromised immune system gets this, they could be in trouble.
In addition, the symptoms and the greater vulnerability of elderly people all correspond to what we would expect from a possible precursor of SARS-CoV-2. The way of how I became aware of this outbreak is interesting. Apparently, some Chinese WeChat users posted screenshots of one of the article. A Facebook user from Hong Kong reposted one of the screenshots in a discussion about COVID-19. When seeing it, I did a fast Google search and immediately thought: how could I be so stupid as not to think about doing systematic Internet searches about possible previous outbreaks of respiratory diseases? For now, let us keep in mind that the Fairfax outbreak is just an indication pointing to a possible precursor of SARS-CoV-2. It could be due to a different pathogen, but if we take into consideration all the information above, the conclusion is clear: no matter what it was, the little information we have got tells us that we should investigate this outbreak further instead of simply ignoring it.
Systematic monthly Google search for “pneumonia outbreak”
We can expect precursor strains of SARS-CoV-2 to cause infections of the upper and lower respiratory tract. Infections of the upper respiratory tract mean a runny nose, a sore throat or a cough; such symptoms will hardly make headlines. Several attempts have revealed that “pneumonia outbreak” is the most promising search criterion for covering all possible outbreaks of infections of the lower respiratory tract. This search was conducted in English, German, French and Italian, with only the respective translation of “pneumonia” for French and Italian, since there is no commonly used equivalent of “outbreak” in these languages.
A general search for these criteria will of course return mostly results related to the present COVID-19 epidemic. Google (and other search engines) provide a search function to set a custom time range for the search results. Search for any word or combination of words, and once the search result has been displayed, click “Tools”, “Any time” and select “Custom range”. Since outbreaks tend to last several weeks, searching for one whole month at a time is quite adequate. The first 30 results of each search were analyzed.
The search results returned by such queries are quite revealing. The most important point which leaps out is probably that for almost all results, the cause of the outbreak is visible directly in the few lines displayed in the Google search page. Modern testing is so efficient that whenever an outbreak occurs, it generally takes a few days, a few weeks at most, before the name of the pathogen is known. Even if performed in English, we find information about pneumonia outbreaks not only in the US (with many outbreaks of Legionnaires ‘ disease), but also from Borneo (due to the measles) and a probably false alert about a “pneumonia outbreak” from the Philippines. Some outbreaks are clearly of zoonotic origin, like a multistate chlamydia psittacosis bacterial pneumonia outbreak among poultry plant workers in the US (21).
A second striking thing is the fact that such a research reveals some outbreaks of known viruses which suddenly became more virulent and even deadly. One such example is an adenovirus outbreak (or maybe several separate outbreaks) which started in 2016 in the US. Like coronaviruses, adenoviruses have been known for decades as causing a “common cold”. The fact that such a virus suddenly caused several deaths among young people gave rise to several media reports in 2018 (22) (23) (24). Another outbreak of the same virus family among the South Korean military got some academic attention (25). With hindsight from within the COVID-19 crisis, we might probably consider that these outbreaks deserved more attention.
One more goosebump story revealed by this search? In 1485, a deadly epidemic ravaged England and then the rest of Europe. Merry for dinner and dead for supper, as they said. The plague? The flu? No, probably a hantavirus which jumped over from rodents. The anecdote is from a BBC article from November 2018 (26) about “the next deadly epidemic”.
Another puzzling topic is the “vaping lung illness” which led to hundreds of patients being hospitalized, mainly in the US, in a wave which spread like a virus from the border region between Illinois and Wisconsin to cover progressively the whole area of the country (27) and beyond (28). The number of cases started to increase in June 2019, reached a peak in September and declined until reaching a very low level by November (29). So far, experts have not been able to reach a consensus regarding the cause of this wave. This lead to rumors claiming that the “vaping lung illness” was actually due to a precursor of SARS-CoV-2 (30), which had a mild course of illness unless its impact was multiplied by vaping. However, the presently weak association between vaping and severe course of illness for COVID-19 (31) invalidates this theory. We will probably have to be satisfied with the partial explanation that the presence of vitamin E acetate and the increasing use of cannabis products in vaping products played a certain role and that there were other factors which we still ignore (32) (33).
Possible early traces of precursors to SARS-CoV-2 in the US
A few search results in the US are more intriguing and might point to early traces of SARS-CoV-2. An interesting case is Whoopi Goldberg’s pneumonia starting in November 2018 and causing her hospitalization in early 2019 in a condition which made doctors fear for her life (34). In May 2020, this led her to claim that her pneumonia was due to a precursor form of COVID-19 (35) (36). Should we take her claim seriously? In other words: should we take the claim of a show business star seriously who claims that she was infected with a precursor of COVID-19 in the US in November 2018, when all eminent experts tell us that this virus emerged roughly one year later in China? I might shock a few readers, but the answer is: yes.
The first thing to retain is that Whoopi Goldberg’s name popped up within the framework of a rigorous scientific sampling process. I don’t follow news about celebrities and was not aware that she had made this claim. A short article in NBC Montana provided by Associated Press (37) came up in the systematic Google research mentioned above, searching “pneumonia outbreak” between March 1 and March 31 2019. Since neither the search result nor the article itself mentioned the pathogen responsible for her pneumonia, I did a further search for “Whoopi Goldberg pneumonia”. Actually, the fact that her pneumonia was described in the short article as having infected both lungs had already caught my attention, since this is characteristic for COVID-19. In case an article found through a search does not mention the pathogen, searching further information is part of the standard procedure. The most detailed article I found was on Medpage Today (34); all the details (slow progression of the illness, followed by a dramatic degradation characterized by shortness of breath, low oxygen saturation) corresponded to COVID-19. Even in this detailed article, no mention was made of the pathogen responsible for the pneumonia, when this is the first things which comes up in articles related to a case of pneumonia. This search also brought up an article mentioning that in 2020, she had claimed that her illness in 2018/2019 was a precursor of COVID-19.
Of course we should not take a self-diagnosis at face value. We should remember that among the first 59 patients clinically diagnosed (including by CT scan, etc.) in Wuhan, 41 turned out to be actually infected by the virus. Even experts (some of whom already had experience with SARS) can get a diagnosis wrong before a PCR test. The tools applied here, namely a text-analytic approach, can never replace a lab confirmed test. However, an accumulation of possibly inaccurate testimonies can allow us to reach reliable conclusions if the testimonies reach statistical significance. What is described here is not a full-fledged research project. Conducting such a project takes at least several months or even years. A systematic Google search as described here is more appropriately described as “exploratory research”, i.e. research which is done with as much rigor as possible, but on a reduced set of data, with the purpose of providing a first overview and helping to formulate hypotheses and research questions. What we have to retain from Whoopi Goldberg’s pneumonia is essentially that the media reports from 2019 fit exactly with what we now know to be COVID-19 symptoms. Her later assertion that she had suffered from a precursor of COVID-19 is meaningful mainly because it confirms that the attending doctors did probably tell her that they did not know which pathogen caused her pneumonia. It is obvious from her inviting two attending doctors to her talk show that she trusts them. It is therefore unlikely that the non-mentioning of the pathogen was an omission by the media; it makes it more likely that the doctors simply did not know. Another information from her 2020 statements is also interesting: she does not speak about her pneumonia alone. Here is her precise wording: “I personally think that people like me last year had some form of this and it evolved into Covid-19.” This clearly expresses the belief that she was not the only person at that time to have a similar pneumonia, with the same unknown origin at the time, which retrospectively can be traced to a precursor of COVID-19.
There is actually another article from December 2018 which confirms this information. It also makes it plausible that her attending doctors told her about other similar cases. On Dec. 25, Cincinnati KUTV carried an article (38) by Liz Bonis with the title “Bad cough that won’t quit part of winter virus going around.” Here is an excerpt which say it all:
There’s a warning from emergency medicine specialists if you have a bad cough that won’t go away.
The flu is on the rise, but another nasty virus is also going around.
For weeks now, there have been reports of a lot of illnesses going around, including some gastrointestinal things. But the one that many are hearing the most about is a bad respiratory infection.
It is different from the flu because the flu tends to come on suddenly. With this one, you’ll feel those symptoms set in but they can have bad complications that can range from just time in bed to a visit to the emergency room.
“Recently we have been seeing a big surge of the upper respiratory type of symptoms, the cough the congestion, the feeling really short of breath,” said Dr. Kenneth Patton of Bethesda North Hospital in Cincinnati.
By the time they are wheeled in, Dr. Kenneth Patton says that shortness of breath is really evident.
“They are retracting, their ribs are doing a lot of work. You can see their neck muscles, you can really see that they are having a hard time breathing,” said Dr. Patton.
He says he has big concerns it will continue to spread this holiday weekend at the family get-togethers, especially to older adults.
“A common cold to you and me, maybe a very serious pneumonia or illness for them,” said Dr. Patton.
This is not just about one case, or about a limited outbreak. This information comes from ER doctors, it matches all the criteria we would expect from a SARS-CoV-2 precursor and, most importantly, it contains no information about which kind of virus it could be, just “another nasty virus”, “different from the flu.” We can safely assume that as soon as a patient arrives at the ER with a pneumonia, doctors will do what they can to determine the cause. This is all the more true when doctors have to deal with a wave of such patients, and this virus is described as being quite common: “But the one that many are hearing the most about is a bad respiratory infection.” If so many ER doctors are hearing about this, why does still nobody know what it is? Why have there been no other reports later on with at least the name of a bacteria, virus or fungus? Or maybe there were such reports, but we missed them? Anyway, even without such reports, it is obvious for everybody who worked in a similar environment that experts an all fields talk to each other and exchange important information without the need for any publication. And yet, the testimonies mentioned above by Whoopi Goldberg and journalists like Fredrick Kunkle and Liz Bonis are all we have got about this mystery virus. On request, Fredrick Kunkle, who had authored the two Washington Post articles about the Fairfax outbreak, tweeted back (39):
We asked Va. officials in April  and were told: “Testing of specimens collected during the Greenspring [Fairfax] outbreak in 2019 showed several bacteria, including Haemophilus influenzae (H. flu). In addition, several specimens were positive for rhinovirus, the cause of the common cold.”
I was therefore not the only one to have suspicions about this outbreak, but still in April 2020, the pathogen responsible for the outbreak had not been found, since we would expect it to be present in all the samples. Within the present context of the present COVID-19 epidemic, it is absolutely crucial that all these events are investigated.
Other articles brought to light through this search are equally interesting. An academic paper (40) describes an outbreak in a nursing home in Louisiana from November 2017 which matches in all points the outbreak in the nursing home in Fairfax mentioned above. In the case of Louisiana, the cause was found quite easily: it was NL63, a coronavirus known for causing “common colds”. When coronaviruses, no matter how different they might be from each other, cause pneumonia outbreaks, the resulting symptoms and infection patterns can often be very similar.
One possible trace in the UK
The search also revealed an outbreak in a nursing home in Great Britain in January 2019 (41) (42). Despite the number of fatalities being the same as in the Fairfax nursing home and the origin also undetermined, media reporting was limited to two articles in a local newspaper which don’t really provide many details. Anyway, the puzzle of the cause of the outbreak is conveyed very well by the following excerpt:
The Care Quality Commission initially said that the causes of death of three residents was believed to have been a flu outbreak. They later said they could not confirm the cause of death.
Virtually no early traces in Germany and France
Interestingly, similar searches in German and French language have revealed no significant traces of any possible precursor to SARS-CoV-2. In Germany, three celebrities were mentioned as having had a pneumonia without indication of the name of the pathogen causing it (43) (44) (45), but no significant details were given which might point to what we are looking for. Like in other countries at the beginning of summer, an article warned about “atypical pneumonias”, which might or might not be an indication that they were more frequent that year than expected (46). The search in French yielded no article of interest.
Mystery pneumonias in Italy
The contrast cannot be bigger between on one hand UK, Germany and France, and on the other hand Italy, where mysterious outbreaks of pneumonia in 2018 and 2019 in northern Italy gave rise to numerous reports across the country.
The most important outbreak started in Brescia in the fall of 2018 and spread to many other towns and villages on the shore of the river Chiesa. It was reported in both Italian (47) and international media. Many of them mention the Legionnaires’ disease as being the cause, but without conclusive proof, as the following except (48) shows:
In all, 405 people have been hospitalized with pneumonia since the outbreak began earlier this month; 42 tested positive for Legionnaires’ disease.
In August 2019, an inquiry by the local attorney into this matter concluded that this was not an epidemic which could be traced back to a clearly defined origin (49) (50) (51). Some of the patients had tested positive for the Legionnaires’ disease, but most had not. The reason why the attorney had investigated was the possibility that some cooling towers in the area had spread the deadly bacteria. Since this was not the case, the attorney stopped investigating. No medical investigation took up the task of determining the cause of the outbreak.
Another much smaller outbreak occurred in spring 2019 in Central Italy, mainly among the staff of a local hospital. Media reports (52) (53) mentioned that the cause was unknown and that the search for it was ongoing. A systematic Google search found no later report mentioning a successful closure of the investigation.
A third outbreak with unknown cause happened in winter 2019 in the western region of Liguria, with three cases of pneumonia per day seeking medical attention in the hospitals San Paolo and Santa Corona (!), mostly of unknown cause, in addition to the ongoing (but relatively mild) flu wave (54).
The systematic Google search also resulted in a series of individual cases of pneumonia, some of them celebrities, but without further details which hinted at a precursor of SARS-CoV-2.
Since Italy is the country with the most intriguing outbreaks of pneumonia in 2018 and 2019 revealed by this method, the question arose whether this could be due to some kind of different “media culture”, where events which would not have interested the media in other countries would give rise to media reports in Italy. An additional search was done for 2017 from April to December. Except for one report about a general increase in pneumonias between 2015 and 2016 in Brescia (55), this additional year revealed no additional noticeable article. This indicates that the search results above point to a significantly higher number of pneumonia outbreaks of unknown cause in Italy than in the other European countries mentioned above in 2018 and 2019.
Finding SARS-CoV-2 outbreaks on the Internet: Successes and failures
The systematic monthly Google searches used in the previous sections are only one possible way of looking for SARS-CoV-2 outbreaks on the Internet. The results provided above show that the method used here can come up with interesting clues which would deserve further investigation.
This kind of method, partially computerize and made more efficient through AI algorithms, is actually used in a systematical way by many institutions, among which the WHO and even some private companies. The WHO press briefing from May 6 (56) provides interesting insights into their system called Epidemic Intelligence from Open Sources (EIOS). This system triggers up to 3'000 “signals” per week by relying on automatic AI-enhanced text mining from various government, media and social media sources (57). The signals are then evaluated by experts who might ask authorities of the country in question for further information and recommend action like sending in expert teams. EIOS successfully triggered an early alarm for COVID-19 in Wuhan.
One of the earliest programs of this kind was set up by the CIA in the early 1970s (58). A more recent project, developed after the SARS epidemic in Canada and run by a private company, picked up one of the very first media reports in Wuhan and allowed the company to warn its clients of a “pneumonia outbreak of unknown origin” on December 31st (59) (60) (61).
All this sounds like a fantastic success story, but it is not, on the contrary. It is the untold story of total failure. The New York Times reported (62) about academic research estimating that by March 1st, 10,000 people were already infected with COVID-19 in New York, by the time the city announced its first confirmed case. In Wuhan, a city twice the size of New York in normal times, there were probably a few hundred or a few thousand cases in all when they realized that they had a problem, even though they did not know what it was and first had to find out. In New York, in Feburay, they knew that there was a virus out there and the genome sequence was available online. There was of course the problem of the faulty test kits provided by the CDC, but for testing at a small scale, test kits are not necessary. Every major hospital or laboratory can perform a partial genome sequencing on RNA fragments. This is much more expensive and takes longer than a PCR test with a test kit, but it is feasible, especially in a major city with some of the best hospitals in the world. With around 10,000 people infected with COVID-19, many must have sought medical attention for pneumonias. Even after the first few cases were finally diagnosed at the beginning of March, it took more than two more weeks before the number of PCR tests started to increase significantly (63).
The instructions from the CDC and the federal government to test only people who had been in contact with China have certainly played a role, but they beg another question: How is it that all doctors in New York blindly obeyed regulations which led to a horrendous public health disaster? And even if doctors all turned a blind eye to the problem, how is it that among all the high-tech AI systems developed to detect health emergencies across the world, not one sounded the alarm?
We have to ask the same questions for northern Italy. If we look at mortality figures for the town of Nembro close to Bergamo which peak around March 10 (64), by the last week of February, this town had reached an infection rate which would put it close to herd immunity (65). That’s the moment when doctors in the province of Lodi, at the opposite side of Lombardy, found the first case of the devastating outbreak in northern Italy. Here again, all high-tech alarms failed. In parts of Lodi, lockdowns were implemented immediately, whereas Bergamo descended into to horror of overwhelmed hospitals and war-time-like triage, which would of course have been far worse if the same infection rate had spread across the whole province instead of a small number of towns.
Is it just a coincidence that the two biggest failures in terms of early detection happened in northern Italy and on the East Coast of the US, precisely in the same regions where the systematic Google searchers above revealed several pneumonia outbreaks which could be early traces of precursors of SARS-CoV-2? Such “coincidences” do not make it more likely that the previous pneumonia outbreak are actually related to SARS-CoV-2. But an accumulation of pneumonias of unknown origin can lead local experts to lower their guard, for example because they think: Oh, yes, that’s what we already had one year ago. No reason to worry about it.
Maria Rita Gismondo, virologist in charge of the bio-emergency laboratory of the Hospital Sacco in Milano, Lombardy/Italy, illustrates this dangerous mechanism. Her Facebook post on Feb. 23, after the first cases were diagnosed in the province of Lodi and led to local lockdowns and a massive testing campaign, immediately got nationwide attention:
To me, this seems madness. You took an infection which is hardly more serious than a flu for a deadly pandemic! [A me sembra una follia. Si è scambiata un’infezione appena più seria di un’influenza per una pandemia letale.]
In some media reports, she got support (66) (67), in others she was harshly criticized by colleagues for downplaying the danger emanating from this virus (68) (69). A Twitter search showed almost unanimous support for her. Since then, she has consistently voiced her opinion that the seriousness of the epidemic was greatly exaggerated by the media. Her advocacy can probably be blamed in part for the fact that measures for containing the virus were taken only reluctantly, which led to a high number of cases and deaths.
This emphasizes the importance of spotting both present and past outbreaks, since past outbreaks can have an impact on the handling of new outbreaks. It is all the more difficult to understand why the highly elaborate search tools which we have got at our disposal have so far not been used to detect either past or present outbreaks. In the past months since the first alarms went off regarding Wuhan, there has been an obvious unwillingness to look for any relevant information about the origin of the virus outside of China. Only in very recent times did some voices question this otherwise perfect consensus among Western media and academia (see below).
Other early traces of SARS-CoV-2
One of the elements which has recently increased acceptance for the idea that SARS-CoV-2 might have emerged somewhere else than in China is the recent research about the presence of the virus in waste water. In three countries, namely Spain (March 2019) (70), Brazil (November 2019) (71) and Italy (December 2019) (72), the virus has been found in waste water samples taken before the virus was identified in Wuhan.
Another source are early patients found through systematic search of medical records or through their own testimony. In France, retesting virus samples and combing through lung scan images of patients hospitalized for pneumonia revealed confirmed cases on Dec. 2 and 29 as well as suspected cases on Nov. 16 and 17 (73) (74). This followed earlier testimonies collected by the French magazine Le Politique (75). The same magazine then published internal documents from the Italian administration showing that some kind of “serious flu” often characterized by “severe pneumonia” was closely followed by health officials from December 4 2019 on (76). This corresponds to several media reports about Italian health experts mentioning cases of “atypical pneumonia” in the fall of 2019 (77) (78) (79). However, no systematic investigation followed these early leads. In the US, various investigations revealed cases on the West Coast in November and December 2019 (80) (81) (82) and one testimony on the East Coast (83). Unfortunately, on the East Coast, where most indications of possible precursors were found, no systematic investigation was attempted.
Some experts have voiced skepticism regarding some of the findings mentioned above (84). However, once results are published, they can relatively easily be verified. The most important seems to be that once a systematic search is started, such projects can come up relatively fast with concrete results. This has also been shown to be the case with the relatively simple systematic Google search described above. It is all the more difficult to understand why such systematic efforts have been undertaken only sporadically in a few regions, instead of being conducted systematically. Many experts and even the WHO have emphasized the urgent need to find out more about the origin of this virus. It is time that these words are followed by action.
The Huanan Market in Wuhan: origin or superspreader event?
Is it relevant to know how the virus could possibly jump from bats to humans, since we know that the spillover event happened at the Huanan Market in Wuhan? Most of the first COVID-19 cases found in China were linked to this market, and since it had a section with wild animals, it was initially suspected of being the place of the original spillover event, i.e. the place where the virus jumped from bats or another intermediate host to humans (85) (86). However, some experts had doubts regarding this theory, and on Feb. 22–23, several media from mainland China (87) (88) (89) (90), Hong Kong (91) and other countries (92) (93) reported that new research had revealed that this was not the case, that the market had only been a place where intense spreading took place, but that the virus had circulated among humans well before it arrived there.
Virtually all influential Western media outlets ignored this information and some of them, among which the BBC (94), The Guardian (95) and Business Insider (96), immediately published stories reemphasizing that the spillover was thought to have taken place at this market. All the three articles were published between Feb. 25 and 26. None of them provided any reason for ignoring the Chinese research results. All three emphasize the importance of finding the origin of the virus and blame capturing wild life (BBC), fur farming (The Guardian) and wet markets (Business Insider) for the origin of the epidemic. Not one of them mentions that wild life hunting is widespread for a broad variety of game in Western countries or that the EU produces more fur in its fur farms than China (97). More importantly, not one mentions the extremely frequent contact between bats and humans in all regions of the globe, even in Western countries. Sometime between April 14 and April 17, the Business Insider article added the information (98) that the Huanan market is no more believed to be the place of the SARS-CoV-2 spillover, but keeps its headline unchanged, which claim: “Both the new coronavirus and SARS outbreaks likely started in Chinese ‘wet markets.’” It is difficult not to see here a case of the Western media reasserting their preferred narrative when it is challenged by academic research coming from China. This clinging to a China-bashing narrative which is attractive to some their readers, but is an obstacle to finding important information to help us fight against a deadly epidemic, is unacceptable and must be investigated.
In the following months, even among Western researchers and government officials, there was very limited awareness at best that the Huanan market was probably not the place where the spillover took place. Many voices called for an investigation in China about the origin of the virus and about the flow of information and measures taken in the early weeks of the outbreak. In a general article in the New York Times about COVID-19 first published on January 23, even the June 1st update (99) still mentions the Huanan market as the place where experts believe the spillover to have taken place. Meantime, precious time was wasted in the quest for reaching a better understanding of the virus.
On April 28, a journalist at the same Guardian started to have some doubts about the spillover event at the Huanan market (100):
In the public mind, the origin story of coronavirus seems well fixed: in late 2019 someone at the now world-famous Huanan seafood market in Wuhan was infected with a virus from an animal. […]
But there is uncertainty about several aspects of the Covid-19 origin story that scientists are trying hard to unravel, including which species passed it to a human. They’re trying hard because knowing how a pandemic starts is a key to stopping the next one.
Unfortunately, expecting that the Western media realize that they clung to the story of the Huanan market origin despite evidence to the contrary is asking too much. It required repeated statements by WHO officials (101) and the publication of new research results both from Western (102) and Chinese researchers for the Western media to concede (without admitting any wrongdoing) that the Huanan market was probably only a superspreader event and was unrelated to the origin of the epidemic. The most absurd reaction is an article in the New Zealand Herald (103) claiming that new research contradicts “Beijing’s claim” that the virus spillover happened at the Huanan market. The article then goes on accusing China from preventing research into the origin of the virus, when Chinese scientists and media tried for months to explain that this is not where the spillover happened.
The 2019 Military World Games in Wuhan
If the spillover event from animals to humans did not happen in Wuhan, then how and when did the virus arrive in the city? There are some indications that this happened during the 2019 Military World Games which took place from Oct. 18 to Oct. 27 in Wuhan. Athletes from several countries were quoted in media reports saying that when coming back from these games, they had an extraordinarily severe respiratory illness whose symptoms were identical with those of COVID-19. A first report on a French local TV channel at the end of March has since then been deleted, probably after pressure from the Ministry of Defense (104). It was followed by a wave of reports from several countries in the first half of May (105) (106) (107) (108) (109). Éric Caumes, a French expert in infectious and tropical illnesses, claims that the symptoms described by the athletes would “make us think” that the illness they got was actually COVID-19 (110).
Two attempts were made to test delegation members with antibody tests. The first one by RTBF, the public Belgian French-speaking broadcasting service (111), tested “three members of the delegation”, without even specifying if these members have fallen ill or at least had some symptoms after coming back from Wuhan. It seems unlikely that they tested members of the delegation who had symptoms, but omitted this important information. If indeed the people who were tested have had no symptoms, the negative test results reported in the article are meaningless. This would also invalidate the conclusion of the article that these tests make the SARS-Cov-2 precursor hypothesis less plausible.
Another article (112) informs us that among 167 members of the Spanish delegation to the Games, 138 took an antibody test and 6 of them tested positive. Here too, the problem is that we don’t get the results separately depending on who showed symptoms or fell ill after coming back from Wuhan and who had no symptoms at all. 6 out of 138 is a rate of 4.3%, which is even lower than the average rate of around 5% of positive antibody tests among the Spanish population (113). In other words, both antibody studies conducted on members of delegations to the Games are entirely worthless.
Putting things together: What plausible scenarios do we have for the origin of SARS-CoV-2?
A certain number of arguments speak against SARS-CoV-2 having jumped from animals to humans in Wuhan or in other parts of China. First of all, there are simply too many indications of earlier presence of this virus or its precursors all around the world. Several phylogenetic analyses performed on all the virus samples taken in China conclude that the most recent common ancestor dates back to a date between September and December 2019. In China, many virus samples were taken very early on, beginning on December 24 in Wuhan and shortly afterwards in other provinces. If an older precursor had circulated among humans in Wuhan or in the rest of China, from which the sampled viruses could have emerged, it is unlikely that these precursors could all have disappeared before sampling began. In addition, sampling in China was done quite on a large scale, in particular at the beginning of the outbreak; in December, Wuhan probably had only a few hundred or at most a few thousand cases. On the other hand, the systematic Google searches above and other data like sewage water analysis have revealed several possible outbreaks in other regions of the globe, but sampling in these places started only in February or March, with a much higher number of cases.
Furthermore, as mentioned above, some research has shown that the earliest samples we have got were already better adapted to replicating in human bodies than to any other possible host animal. The authors of this study claim that this proves that the virus was cultivated in a lab where it had time to progressively optimize to replicate in human cells (12). Obviously, every noob will realize that there is another possible explanation: this virus was already circulating for quite some time among humans, but was not spotted before one last mutation allowed it to spread fast enough to cause a major outbreak in Wuhan which alerted some doctors. This hypothesis is supported by several researchers (114) (115). The outbreak in Brescia in autumn 2018 caused more than 1000 cases of pneumonia and the outbreak on the East Coast of the US brought enough people into the emergency room for doctors of several hospitals to alert each other; however, none of the outbreaks mentioned above led to a successful search for the responsible pathogen.
Recently, a British researcher claimed that SARS-CoV-2 could have remained “dormant” all over the world until some environmental conditions activated it, leading to an outbreak which started in China, but could have started anywhere else in the world (116). One of the examples he gives, namely the fact that the Spanish flu emerged in Western Samoa even though “they hadn’t had any communication with the outside world” is based on more than shaky evidence; a freighter is actually thought to have brought the virus there. Anyway, this indicates that the recent discoveries of SARS-CoV-2 in waste water before the identification of the virus in China, quoted by this researcher, have shaken the confidence that this virus jumped over to human in China and from there spread to the rest of the world.
Another argument against a spillover event in China is the fact that the Chinese bats are certainly the most thoroughly investigated bats in the world. The same is true, to a somewhat lesser extent, for the rest of Southeast Asia. The closest “relatives” to SARS-CoV-2 which have been found there so far in China or all of Asia are separated by several decades of separate evolution from SARS-CoV-2. This shows that it is urgent to spread the scope of the research for the origin of this virus beyond China and Asia in general.
If we put all of this together, it seems more and more likely that this virus circulated among humans for quite some time. This hypothesis was actually defended by some researchers as far back as March 2020 (115), but was rejected or ignored by the rest of the Western academic community and the Western media. As a result of all these considerations, we get a huge variety of possible scenarios. There might have been only one or many thousands of different spillover events; in the latter case, most outbreaks would have fizzled out because the virus was not well adapted to the new human host. In one case, an unknown number of mutations somewhere in the world would have allowed it to spread further. The Military World Games in Wuhan probably played the role of a superspreader event. If we consider the kind of interactions which happen among athletes and between athletes and locals, it is more likely that the virus was brought to the games by one of the more than 100 delegations coming from all over the world. The virus spread to other delegations and also to some locals from Wuhan where it spread unnoticed for some time within this city. Two more mutations which are well documented allowed it to spread faster, leading to a first local superspreader event at the Huanan Market. There are indications that the virus strain responsible for this outbreak was still relatively slow in spreading; closing the market on Jan. 1st and some first measures led to a temporary decline in new cases. This strengthened the initial hypothesis that the spillover event had taken place a short time ago and that the virus was not yet adapted well to humans, giving rise to hopes that the outbreak would fizzle out by itself. Another mutation then seems to have given it a new boost, leading to the lockdown of Wuhan on January 23 and subsequently of other Chinese regions. After these mutations, the virus was ready to spread all over the world, after a further increase in replication and spreading speed through additional mutations which happened in Europe. Some of the claims made here are the result of own data analyses which will be published shortly.
Hopefully, this article can make a convincing case for more thorough research into the possible origin of SARS-CoV-2, including through existing tools which were so far neglected like Internet-based outbreak warning tools and media analysis. We must also ask ourselves why these tools worked so well in detecting the outbreak in Wuhan, but failed in detecting bigger outbreaks in Europe and the US, even though these events would have been easier to detect since the threat and the target virus was already known. Last but not least, we must investigate the reasons why crucial information coming from reliable sources was systematically ignored for months by most of the Western media and academia. These problems in information transmission not only handicapped our search for the origin of the virus and for a better understanding of the virus. These problems also triggered a massive wave of anti-Chinese and anti-Asian hatred and a huge increase in attacks motivated by racism. In the midst of a deadly epidemic, all forces must be focused on saving lives, and those who don’t understand this must be held accountable.
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