Transcript
COVID-19 Briefing: The WHO-China Mission
Professor David Heymann CBE
Distinguished Fellow, Global Health Programme, Chatham House, Executive Director, Communicable Diseases Cluster, World Health Organization (1998-2003)
Dr Peter Daszak
President, EcoHealth Alliance
Professor Marion Koopmans
Head, Department of Viroscience, Erasmus University Medical Center, Rotterdam
Professor John Watson
Senior Medical Adviser, Health Protection and Medical Directorate, Public Health England
Chair: Emma Ross
Senior Consulting Fellow, Global Health Programme, Chatham House
Event date: 10 March 2021
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Emma Ross
Good afternoon and thanks for joining us again for the Chatham House COVID-19 webinar series, with our Distinguished Fellow, Professor David Heymann. Today, we’re going to take a look inside the WHO- China joint mission, whereby an international team of experts, corralled by WHO, went to Wuhan last month to collaborate with Chinese colleagues to study, among other things, how this all started. Our guest experts today are three members of the international team: Peter Daszak, Marion Koopmans, and John Watson. Peter’s an expert on the cause and spread of zoonotic diseases, i.e., diseases that can be passed from animals to humans. He is a long-term research collaborator with Scientists at the Wuhan Institute of Virology, studying bat coronaviruses and worked on the animal environment aspects during the mission. Marion’s a Virologist, who specialises in emerging infectious diseases. She was on the team that found, in 2013, that dromedary camels were an intermediate host for the virus that causes MERS, and during the pandemic, she has tracked the spread of the virus in minks, mink farms in Europe. In Wuhan, she was involved in the molecular epidemiology group sifting through the viral sequencing data. John is an Infectious Disease Epidemiologist and an expert in the surveillance, prevention and control of respiratory infections, who’s overseen responses to a range of outbreaks, from SARS to pandemic flu. In Wuhan, he was on the epidemiological team that considered the information about the occurrence of the virus in humans. So, welcome to you all, bit of a long introduction, but I think you have such a varied expertise to bring to this conversation, so it’s great to have all those aspects gathered together.
Just a bit of housekeeping first. To ask questions at any time, please write them in the ‘Q&A’ function on Zoom. Upvoted questions are more likely to be selected, and this event, as always, is on the record.
Oh, okay, you lot, let’s get started with this. So, Marion, I was hoping you could orient us first and talk about how these kinds of missions are set up and how do they work? I mean, what’s the dynamic between – within these joint missions, between the hosts and the international visitors, and you’ve been on a few, over the years, is there anything special about this one?
Professor Marion Koopmans
Yeah, well, let me start with this one, because, yes, I think this one is special, by all means. So this was really set up – so we were asked to look into this ultimate question, can we really understand what this – what started this pandemic, how did – what happened there, what was the origin of this pandemic? And that is a question that was discussed already by the WHO team in their first visit in Wuhan, and it was set up as a scientific series of studies to be co-developed between an international team of experts and Scientists on the ground in China, to really step back – step wide to try and, yeah, understand this important question. So, the way this is done is that we have started to work, mostly online initially, already in the months before this mission, building from a series of so-called phase one studies where we asked a lot of questions, a lot of information from our Chinese colleagues, and they started to work on those studies. And since our visit, so what we’ve done there is also initially online, later face-to-face, go over all the studies, look at the data that they had gathered, look at the analysis, suggest additional ways of analysing that data, and really scrutinise it, discuss it, and see what we could conclude from that. So, that’s been the process.
There is, I think, a bit of a misunderstanding out there, if you hear some of the comments where people think this is like an inspection, that’s not what this was, this is a scientific joint collaborative study trying to deeply understand what happened in the early stages of this pandemic. So, the first focus was on going to the place where, of course, the first cases were identified and trying to get a deep understanding of what happened in December, maybe the months before that, as a starting point, looking at the market, what
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happened there as a starting point, and then working backwards from there. So, we see it as a starting point, not the mission that will give the answers, I think that’s also another common misunderstanding.
Emma Ross
Okay, thank you for that introduction.
Professor Marion Koopmans
And maybe in terms of how it is, what you were asking, how is it to work, so, indeed, I’ve been involved in other studies like this, both nationally and internationally, so these are complex endeavours. You have to bring together information from many different sources, from the medical side, public health side, from the veterinary side, that by itself, in many countries, is already – it’s not necessarily linked. You have to get to know the colleagues on the ground and their expertise and their way of working and their culture of working. And, of course, we had here the handicap of the – you know, being in quarantine, full-blown quarantine first for 14 days and then, with restrictions in the second half of our visit. So, none of that is really conducive to the type of discussion you would want to have, when you sit around the table, look at data, scrutinise data. But was, I think, what was exceptional in this one, I’m sure Peter and John have things to say there, it’s just the sheer amount of interest from the media, and of course, that this is a study in the middle of, well, a bit of a geopolitical debate that has its own ideas. So, that was – well, it is a more complicated setting, but as a team, we really have worked hard and discussed extensively that we really want to try to stick to the science and work in a scientific process, also with our colleagues in China.
Emma Ross
Yeah, well, what was the dynamic like? What’s the set up with the dynamic between the host team and the international team and also the scale of it, ‘cause there were ten international experts, what about on the other side and what was the dynamic between you?
Professor Marion Koopmans
So, there was a core group of experts, but there was also many people around, because what you have to understand that the list of studies that we settled for was long and people will be able to see that once the final report comes out. So, and what we heard is that around 1,000 people have worked to get the data to the point where we could, you know, discuss them, scrutinise them, review them, during our one month visit. So, these were staff from the different level CDCs, from the Wuhan CDC, the provincial CDCs, the China Central CDC, from the laboratories, so depending on the topics, several of those people would be around as well in the meetings. So, what we did is tried – well, we had our online period first, which is challenging, as we all know by now, and then, once we were able to sit face-to-face, we had a mix of plenaries and then we broke that down into those three theme groups, just to have a bit of different ways of working and interacting, and that, in the end, I think that worked out well.
Emma Ross
Okay. I wanted to go to David now, actually. David, you’ve been on a few of these in your time, these kind of missions, I wanted – I was hoping you could explain briefly what’s the importance of these missions and the work to try and understand the origins of an outbreak? I mean, why do we really need to do this? Does it really matter if we ever – if we never find out? I mean, we are where we are with the pandemic,
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and we’ve got a lot to deal with, what’s the value in going backwards and doing this and how important is it really, at this time, right now?
Professor David Heymann CBE
Thanks, Emma. Well, what’s important is clearly to understand where the infection came from and how it made its way into human populations, for this outbreak, or for any other outbreak, and, you know, it’s quite a difficult job to do that. The first Ebola outbreak in 1976 occurred and still, the vector in nature is suspected, but never been confirmed, by isolating a live virus from that vector. But there have been many studies looking at animals, finding antibody in animals, looking in the laboratory to see which animals could be infected and survive, a whole series of studies going on, but we still don’t have all the information we need, and that’s since 1976.
The SARS outbreak in 2003 though, there was some work going on just after the outbreak was finishing in June of 2003 in China, and in that they looked at market workers in these live animal markets and they looked at three different groups who were paired with those market workers, who lived in the community, but weren’t involved in the market. And what they found was that there was antibody evidence of 13% of the market workers having been infected with a coronavirus, not necessarily the SARS coronavirus of 2003, but a coronavirus, whereas in the populations in those communities, it was from one to 3% who had evidence of infection with coronavirus. So, what was assumed is that market workers are at great risk, but then the studies stopped, and no further understanding was gained. So, hopefully, that will be applied to this study going forward, as Marion said, in the ways that they’ve developed their research activities, so that it can be understood where this virus is the greatest risk, or where viruses such as this are greatest risk, and certainly, one of those risks would be where there’s an interface between animals and humans.
Emma Ross
Yeah. Okay, John, did you want to add anything on this, on the value of going back and looking, as far as preparing ourselves for the future, or even dealing with this pandemic? You’re on mute.
Professor John Watson
Sorry, thank you. Look, if I could just begin by saying that although I’ve done many an international mission, this is the first of this kind, of such a multidisciplinary nature, and with so much external interest and pressure. And so it was a great privilege to be part of that, and it was really, from my point of view, important to have that opportunity because of the kinds of things that David has mentioned, which is the potential to be able to find information that can help us better understand how this has come about, and as a result of that, possibly take steps to prevent that happening in future, or if not prevent it from happening in the future, at least pick it up earlier and, when picked up, potentially learn things that will enable us to be able to control it better, particularly at that early stage. And I think that in doing that, we have come to recognise how this kind of investigation is not just about illness in humans, or indeed just about an interface between humans and animals, but feeds into an altogether wider discussion about the way in which we use the world. The way we use the resources of the world, the way in which we interact with our environment, including the animal environment, and some of the consequences of that, and so it becomes part of that wider discussion as well. So, I’ll stop there for the moment. Thanks.
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Emma Ross
Peter, I wanted to ask you is being speedy really important in doing these studies, or does it not really matter? And I’m just…
Dr Peter Daszak
Well, it really does matter, and, look, let’s be honest about where we are with understanding the origins to pandemics, we’re not in great shape. As David pointed out, we still don’t know the origins of most major pandemics, we have rough ideas, and we’ve gone back over historical time with some of them, and you think about HIV/AIDS and some of the work that’s gone on on that, we need to be doing this in real time as they happen. We need Ecologists and Veterinarians working with outbreak teams to start that work right at the beginning, even if it seems of lesser importance than saving lives and getting people into quarantine and hospitals, because what we’re left with is not – if we don’t understand the origins of each pandemic as they happen, how are we going to predict and prevent future pandemics? That’s the real issue here. We’re always just going to be sat here waiting for them to emerge and that’s not a tenable strategy, I believe, for public health.
Professor Marion Koopmans
But maybe there’s also – I mean, there’s this question, isn’t this too late? That’s a question at least that I get a lot, and I think there’s two answers to it. Of course, ideally, you would do a full-blown, full-detailed investigation right early on when the first things happen, but it’s very understandable that if you are in the middle of an explosive outbreak that that draws the attention, which happened in Wuhan, and which is what was discussed when WHO first visited there in February. So, we’re – if you imagine that Scientists and other staff from all over the country had to be brought in to just be able to handle this early phase of the pandemic. So, I think that’s understandable, and there’s also – there’s things we have learned over the past year that we didn’t know early on. I think we have, from the different experimental studies and the field observations, we have a better idea which types of animals, for instance, to, you know, to think about. We have a somewhat better understanding of the ways these viruses transmit, the super spreading events, and you can bring that knowledge back into how you now look at the information from the very early stages. So, there’s pros and cons about that and it’s certainly not a lost opportunity to start looking into this, even if it’s – if it was a year after the start, or what we think was the start of the pandemic.
Professor John Watson
If I could just pick up on that, Emma, which is that there will, of course, be numerous lessons learnt, and exercises and papers that follow this pandemic, and rightly so. But quite often, of course, one of the things that come out of those lessons learned are how we could better have dealt with the last pandemic rather than necessarily what will enable us to better deal with a future pandemic. And that we will want to be very mindful of trying to build into a future pandemic preparedness things that will enable us to deal with future threats of whatever kind, that don’t look necessarily like this one, but look like any one of a number of others, but – so, flexible arrangements that will allow us to be able to move and move early on getting that information and understanding, that could help with that origins understanding, but doing so in a way that’s flexible and isn’t just about how you track down SARS-CoV-2.
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Emma Ross
Okay, great. So, I want to get on to pick up on what Marion said about the politically charged environment and the challenges of conducting this kind of science in a politically sensitive context. I mean, the challenges of outbreak research are complex enough, as you’ve explained, but plus we’ve got the special politics going on right now, and it seems that this one is a particularly politically charged environment that’s right in the centre of the conspiracy theories and it seems the mission is in the crossfire of the US-China tensions and the accusations that WHO has been too soft on China. You’ve had all sorts of attacks on the credibility of the mission, including an American biosafety expert contending it was a charade. And, Peter, apart from President Trump defunding the bat coronavirus work you’ve been doing with the Wuhan lab, I know you’ve had death threats that have meant you’ve had to muscle up with bodyguards, I can imagine this kind of political context is not something that you, as Scientists, are used to, or maybe you are actually, and that it might make it a bit more challenging to do the work. The question from me is, really how politicised has this one been compared with the others, and I think we’ve probably said it was a special case, but really what has the impact been on the ability to do this work, and how do you navigate the politics? Peter, do you want to start with that one? You can all come in, I’m sure, on that.
Dr Peter Daszak
Yeah, I mean, the work that I normally do does not engender this, sort of, level of political intrigue, but neither did the work that I have been doing that is now part of this political intrigue. You know, there was very little interest in this work prior to the outbreak, despite us repeatedly saying there is likely to be an outbreak of a bat origin, SARS-related coronavirus some time very soon, in the region of Southeast Asia, including China, over and over again. So, it is quite ironic that, despite our work pointing to this risk and trying to understand this risk and get ready for this risk, that you then end up as an organisation that’s under attack for doing that exact work.
But, to be honest, there is something very important about the scientific process that allows you to neatly deal with this political intrigue and the conspiracies, and there’s a scientific process here, which involves looking at data, analysing it, coming to conclusions about what it means, and publishing it, making it public, and that is the scientific process we all learn as students and work on as Scientists, and that’s extremely important because it allows you to do the work, irrespective of the politics. You know, there’s some purity to finding those data, analysing them, publishing them, and then other Scientists repeating that work and saying if it’s, you know, supporting it or refuting it, and I’ve found great solace in that and I think it really helps, and it will eventually point fairly robustly to what the true origins of this pandemic, I’m convinced we’re going to find out fairly soon. Within the next few years, we’re going to have real significant data on where this came from and how it emerged, and I – that’s consistent with other outbreaks in the past.
Emma Ross
Okay, and do you think – tell me more about whether you think that the politically charged environment of this one is anything special, because aren’t pandemics always political? I mean, how bad has it been?
Dr Peter Daszak
Well, I’m in the US, so it’s been particularly bad in the US because, let’s face it, when the previous President launched his campaign, it partly was based on an anti-China agenda from the US, that then
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became a, sort of, faux trade war and just lots of rhetoric that’s been picked up by a huge number of people in the US and pushed and funded. I mean, I’ve seen incredible efforts from everything from Falun Gong to the Miles Guo camp, Steve Bannon’s group, pushing the conspiracy theories around China as part of an anti-China political rhetoric. So, it’s useful to them and they’re funding it and pushing it and science has been, to some extent, caught up in that, to other instances absolutely crushed by it, and what I mean by crushed is, we’ve not had access to work in China on the origins for the last 12 months, which is ironic because we could have been on the ground there working with our Chinese colleagues and by now, we may have had some really important answers as to how it emerged, and the rhetoric has held that up. So, it’s – these politics are not there to help find the origins, they’re simply there to help one political party win, and it’s – that’s the problem, I think, and people are caught up in that and I wish they would wake up and realise that, to some extent, science is being used and abused in that sense.
Emma Ross
Okay. Moving onto the findings, I don’t know, Peter, do you want to start, or Marion, or whoever wants to start, which is what’s the upshot of your key findings from the mission, and where we are as far as understanding how this happened? I mean, what was the most exciting thing you found out, or that’s, you know, the leading theory?
Dr Peter Daszak
Well, I’ll tell you from the animal side, the animal environment side, which is what I was the co-chair of for the WHO team. What we’ve found, I think, there are a couple of very interesting things. You know, we’ve got a market in Wuhan where there were quite a few cases linked to, early on in the outbreak, so we’re looking at are these markets places where animals that could carry coronaviruses were sold, number one? Are there other markets that are similar in the region? Is this just a one-off, is this an unusual place? Did people in a big city like Wuhan still eat these traditional wildlife? And the answer to those questions was yes, and I think quite surprisingly really that, for many of us, a big city like Wuhan had a live animal market, there were live animals sold there, although we were told repeatedly not mammals that were live. What we did see data from the Chinese side on were that animals in the market that we know are able to either be infected by SARS coronavirus, or SARS-CoV-2, were present in the market. We only know that from frozen animals that were left behind when the market was closed. We also found that there was a conduit from Wuhan to the provinces, where in South China where the closest relative viruses to SARS-CoV-2 are found in bats. So, I think that’s quite important, and it provides a link and a pathway by which a virus could, you kn0w, convincingly spill over from the wildlife into either people or animals farmed in the region, and then shipped into a market by some means. So, that’s a really important clue and those beginnings of an understanding of the pathway need to be followed up pretty rapidly, I think.
Emma Ross
So, was it that you didn’t find a close relative of this virus in bats in Hubei where the market was, but you…
Dr Peter Daszak
Yeah, true.
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Emma Ross
…a remote area, so indicating that it was in trade and – that it was brought to rather than being from around?
Dr Peter Daszak
Yeah, look, if – when the report comes out, I think that people will see quite a huge amount of work that’s been done by China in the last 12 months, including testing tens of thousands of animals across China, looking for evidence of SARS-CoV-2 getting into them, or other coronaviruses. And Shi Zhengli, from the Wuhan Institute of Virology, actually went out to Hubei Province and collected bats and looked at over 1,000 bats from that province to see, you know, is it a local virus that’s carried by bats that got into the market? And the answer is no, not yet, the – in 1,100 plus bats, no evidence of a SARS-CoV-2 relative.
Now, that doesn’t rule it out, but it’s evidence that’s part of this, sort of, understanding of the hypotheses. So, the Chinese side did do quite a bit on the animal environment side to really try and understand origins, including swabbing 900 plus samples from that market, under pretty horrific conditions, in the middle of an outbreak, everything from sewage to the insides of body cavities of frozen, rotting animals, you know, there’s not much more you could have done, given the market was closed and abandoned at that point.
Emma Ross
So, are you saying that wildlife trade is key to this and something needs to be looked at, or…?
Dr Peter Daszak
Well, you’ll see from the hypotheses that we all passed our opinion on that that hypothesis is the one that’s most strongly supported by – both on the WHO side and the China side, that a bat or other wildlife species carried a virus that’s a progenitor of SARS-CoV-2, it got into domestic animals, wildlife, bred in farms perhaps, or people associated with that, and got into the Wuhan market that way. I believe that’s the most likely scenario and I think most people, on both sides of the mission, felt the same way.
Professor Marion Koopmans
Yeah, maybe also important to mention that there has been – so, the screening involved the major livestock species from several provinces, also by serology, and if you compare that with, for instance, what we did at the early stages of MERS, just with a fraction of that amount of screening, we just hit the dromedary camels as the species to look into. So, in retrospect, that was luck, but in – so, here, China has done what is a feat of something like 30,000, a lot of testing of animals across the country, not finding such evidence, which is also important, so that does, sort of, say, well, any other common livestock species are not likely to have been involved. And then, of course, moving the question back to the more rare – or rare, maybe not, but wild animals or farmed wild animals, where you then have to think about what is a way of sampling to rule those in or out, and that’s, of course, a next step.
Emma Ross
Okay, great. I’m going to – this is a good time to go to the audience questions. By far the most upvoted question is from Friso van der Veen, “If your mission is just a starting point, why does there seem to be
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such an effort to dismiss the lab leak origin hypothesis? Do you agree that your mission cannot make any conclusions about this hypothesis?” Marion, do you want to start with that?
Professor Marion Koopmans
Yeah. So, maybe it’s good to explain how – what it is that we did. So, what we put together is what is a – so we put together a diagram, which also will – it has been shown at the press conference, it will be in the report, saying what are possible ways of introduction of a virus into the population, assuming animal, bat or other animal origin, and that included also the laboratory route, and then look at all the information that we were presented with, the studies that have been done, and also including information that we have gotten, through in-depth discussions with our colleagues in the laboratories, looking at what the epidemiology pointed at, and then went through more or less structured process saying, okay, what, given everything we see here, is highly likely or – most likely, least likely? And that’s how we did that, and from – so we have visited the three laboratories that have been actively working, including the laboratory sitting close to the market, including the Wuhan Institute of Virology, we have discussed their research programmes, their routine testing programmes, the way they work, their – what they had done, in terms of health monitoring and testing of staff, and, based on that, we concluded that it’s extremely unlikely that there was a lab incident.
Now, what you hear people say, and I think this is about expectations, if you then say, I don’t believe that, well then that’s a very different story, but that’s not how we have approached this. We have approached this, what does the evidence tell us, we do not find evidence, and what we have been saying to people that say, “Well, but it has to be something else,” well, please provide what evidence you have to WHO and then it will be taken into consideration. But we cannot work on the basis of speculation, we work on the observations that we have.
Emma Ross
Does anyone else want to come in on that? No, okay. The next most upvoted question is from Nina Larson, “Could you say how many sites the Chinese agreed to before the team arrived, and how many sites you were ultimately granted access to?” And I think at the bottom of this is “Do you think any of the sites that were removed from the list were vital to the origins probe?”
Dr Peter Daszak
Let me briefly answer this, ‘cause it’s based on a misconception. No sites were removed from the list. We asked to visit a series of sites, while we were in quarantine, on our teleconference calls with the Chinese, we talked about this and said, “We’ll send you a list.” We sent a list of sites and people we wanted to talk to and none were refused and we got to them all. It’s fairly simple. I think we’ve said that pretty publicly, and there’s just no controversy there at all.
Emma Ross
Okay. I’m going to take one from Filippa Lentzos, “Are you comfortable with the way in which the media has portrayed, and people have understood, your study tour as a neutral WHO investigation rather than a joint WHO/China study?” We kind of discussed this a little bit, but that’s a slightly more specific question. John, do you want to start on that one?
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Professor John Watson
Sure. I wasn’t quite clear about the distinction that was being drawn there, because there’s no question that this was set up as a joint study and that’s the way we set about it and that there were a series of studies that were agreed, prior to the establishment of this team to be done, and that the process that we set about was one of then reviewing those studies with our Chinese counterparts, getting them to explain precisely what had been done, how it had been analysed, what the results were. There was then an iterative discussion about those analyses and further analyses, some of which it was possible to see and talk about there and then, and some are things that we hope we will be able to see going forward, because this was only a start. But this was set up as a joint mission and I think, as perhaps it was Marion at the beginning reminded us, what this was not set up as was an external group coming in to investigate and to point fingers and with the hope of identifying a smoking gun. It wasn’t that kind of investigation.
Emma Ross
Okay, thank you. I’m going to take a press question now, and this is the most upvoted press question, I think, Maria Cheng from Associated Press, “Did the Chinese provide any genetic sequencing data to substantiate their theory the virus could be spread by packaging on frozen seafood? If so, how convincing are these data?” Marion?
Professor Marion Koopmans
Maybe I can take that. So, yeah, so what one of the pieces of the studies was to bring together all the genetic sequence data that has been generated in China and trying to link that with as much as possible, with the data from the Epidemiologists. Now, that seems to be – that sounds simple and it is not, globally it’s not, if you look at the GISAID database, for instance, it’s really difficult. So, what was looked at there – so that was done, and certainly for the early phase, the first month, so the December cases, but in that process, we also reviewed what was available, in terms of environmental sample data, that’s how I will label them. So, indeed, these were sequence data generated during outbreak investigations since June/July, where they have seen resurgence outbreaks in regions where there hadn’t been cases for a long time, and so that – and one, I think, the best, the most exhaustive studied outbreak was the one on the market in Beijing, but we’ve also seen – or that has been presented again, and there all the epidemiology pointed to a risk factor associated with stalls where frozen food was sold, and environmental contamination, and there are sequences with that. That, of course, does not prove it’s in the product or on the product, but since then, China has started to screen and they have done – well, they explained to us 1.4 million screening episodes, with not very many, I think 30 plus positives, so that’s really very rare occasion, but where they do find sequence data that they then have compared with sequence data from the rest of the world, saying, “Hey, this is likely to be newly imported.”
From the studies, and we have also written that down in our report, so there is enough pieces of information that you really have to say, well, let’s look into this. There is – there was the initial idea coronaviruses are not stable in freezing, but there was some experiments, also WHO asked groups to do some experiments, they spiked the virus onto fish, put it in the freezer, thawed it out three weeks later, and were able to culture the virus back. So, that’s possible. So, we cannot completely rule it out, but, of course, you have to make a distinction between importing products from regions in the middle of a pandemic, with many people infected, possibly handling those products, and that could lead to contamination from – could that have been the origin? The origin most likely, of course, is not the answer out of a package, it’s maybe frozen wild animal meat, that’s what we think is still very, very valid option.
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Emma Ross
Okay, thank you. Carrying on, on which theory…
Professor John Watson
Emma?
Emma Ross
Oh, yes, go ahead, John.
Professor John Watson
Look, apologies, can I just very briefly come back to the question that preceded that one about the way in which the mission was set up, because there was one element that I missed, which I think is important. I emphasised the joint nature of it between WHO and China, but a crucial element is that the WHO team was made up of, at its core, ten independent experts drawn from around the world, people who were neither beholden to WHO nor indeed to their own countries of origin, and that independent element, I think, is an important part of the way in which the mission was set up and the way in which what we conclude from it, and this is a bunch of disparate independent people, the weight that’s placed on what we conclude from it. Thanks.
Emma Ross
Okay, thanks. Just before I let you go, John, the question that you took from Filippa Lentzos, who was asking about the way the media has portrayed and people have understood the study as a neutral thing, she’s followed up to say, “Thank you, John, but that doesn’t answer my question about media representation and people’s understanding of the trip.” Is there anything more you wanted to add than what you said? I’m afraid I forgot what you said.
Professor John Watson
Right, no, look, and forgive me and forgive me, Filippa, that the issue of the media representation has been touched on already. It’s clear that there is not only a political agenda here with a wish potentially to see certain outcomes for the conclusions to the report, but also a popular perception about a group of Sherlock Holmes going in with magnifying glasses and swabs to identify something in that kind of investigation, and I hope that in an earlier answer, I’ve emphasised that that was not the way in which the mission was set up, but rather as a set of joint scientific studies and a shared review of those studies.
Emma Ross
Okay, thanks. I’m going to go back to which theory should be given and how much truck. This is an upvoted question, maybe not the most upvoted, but still on topic, Mark Smolinski, and he says, “It is not a conspiracy theory to consider a lab incident with a newly emergent disease, it’s part of the proper consideration of all possible causes. In this particular incident, it would be expected that China would be studying coronaviruses in their lab, given the history with SARS. We need to move beyond the rhetoric and rule out or rule in that this is not the case. Mother Nature, bioterror, or bioerror, bioterror must always be considered in every novel virus. Do you agree?”
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Professor Marion Koopmans
I agree, and we did, I think, we discussed it at all our visits, it was discussed openly, even though, of course, this is a tough topic because of – because this is part of the more political side of the discussion, and so – and we reviewed everything that was done and the viruses that were worked on were very distant from the virus, as we have come to know it, as SARS-CoV-2. There has been work done and there are several publications out that have looked at the genomic constellation of the virus and that have explained some of the markers that were initially mentioned as – that something that must have been put into the virus have also been found in nature. So, we looked at all those elements and, for us, reached the conclusion, we think this is the least likely of our list of hypotheses, and, again, saying if people have other evidence, please share that with WHO, so it can be taken up, but we have not seen any pointers to follow that up.
Emma Ross
But it hasn’t been ruled out?
Dr Peter Daszak
Let me come in on that. I mean, the problem is, you know, ruling out involves proving a negative and we – to rule out the lab leak depends on your level of belief in that hypothesis. If you firmly believe that whatever we hear from our Chinese colleagues over there in the labs is not going to be true, then we’ll never be able to rule it out, and I think that’s the real problems with some of this. And, you know, Mark, you’re right that in its essence that theory is not a conspiracy theory, but many, many people have put that forward as a conspiracy theory in that the Chinese side conspired to cover up evidence of that. Thanks.
Professor Marion Koopmans
And that’s how we discussed it, because there was a discussion at some point, “Isn’t this impossible?” And we said, “Scientifically, you can never say it’s impossible.” So, that’s why it’s not there, it’s not there as impossible, it’s there as really very unlikely, based on our observations.
Emma Ross
Okay. David, you look like you wanted to come in?
Professor David Heymann CBE
Yeah, taking a look at this from the outside, there are some conspiracy theories, those theories are that this virus was manipulated in the laboratory to cause harm. Those are some of the conspiracy theories that I’ve read. But on the other hand, laboratory accidents do occur, and I think the team has agreed that they do occur, in fact, as we all know, the last case of human smallpox occurred from a laboratory accident in United Kingdom. And so, laboratory accidents occur. The last cases of SARS occurred, in 2003, occurred with a laboratory accident in Singapore. So, we know that laboratory accidents can occur, and what the team is saying, and this is for Mark in particular, that there was no conspiracy that there could have been a leak, but this conspiracy theory about manipulating a virus in the laboratory, is what many people are basing their belief on, and I think there’s probably no evidence for that, but, again, that’s my own view.
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Emma Ross
Why don’t we deal with that upfront, is there any evidence of manipulation or deliberate use?
Dr Peter Daszak
Briefly, then others can come in. I’ve not seen any, I’ve also not seen any evidence of an accidental lab leak from the lab. I mean, it’s a really important point, there is no actual evidence of a lab leak from any of the labs in the vicinity. There’s just a circumstantial geographical proximity of those labs to the centre of an outbreak, that’s it. So, if that’s the evidence we’re basing it on, what can you do? You cannot then rule that out.
Emma Ross
Okay, I’m going to go onto another press question now. Sarah Newey from The Telegraph, and there’s two linked questions here, “Do you feel like you achieved what you set out to do on this mission?” Granted, we’ve said this is a starting point. “Were you disappointed by any elements of the trip? Also, there have been some reports that the African swine fever outbreak may have contributed to increased demand for other possibly wild meat. Did you find any evidence of this during your trip? And also, could you tell us a bit more about the conduit that links the animal market to South China and why is that so significant?”
Professor Marion Koopmans
Maybe I can start with that. So, I think I was pleasantly surprised by the amount of work that had been done by the amount of data that we were presented with, and I feel we’ve gotten a much deeper understanding of the initial phase of, well, the pandemic as it was in Wuhan, from the combined studies. It’s – of course, you want to move fast through the next steps, but I think, given the circumstances, this was really a lot of information and new information, and I really encourage everyone to read the report about that. What was very disappointing for us was that, while we were there, the – there was an outbreak, a resurgence of cases, which changed the medical – the quarantine rules, so that meant that the second phase of our trip, after the hotel quarantine, we still could not freely go about, although I doubt that would have been possible, given all the media around, but that was a disappointment for all of us. So, in the – and I think I want to mention it because working in a joint team like that, also in other missions, now the social elements are part of what makes these things evolve. So, you sit in meetings and then you, you know, you have – you go somewhere, you discuss other things, you have a dinner, that helps, that was – we were handicapped because that was not possible. I think that’s a – to me that was disappointing because that’s – that definitely makes life easier.
Emma Ross
Anybody else?
Professor John Watson
Only to agree with Marion, we were shown a lot, but the process was slow because of the quarantine and because of the issues of language and translation, because, of course, of the inevitable time to get to know our counterparts and the way they worked and the environment and setting in which all of this was occurring. So, in that respect, it was slow, but despite that we were shown a very great deal, we recognise
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and we will be asking for the opportunity to take that further, but we’ve learnt a great deal. So, I was not at all disappointed.
Emma Ross
Okay. I’m going to go onto the last audience question. This is the most upvoted by far, so I’m going to go and pick this one. It’s from Steven Quay, “In September 2019, the Wuhan Institute of Virology took online databases containing over 16,000 virus sequences and specimens offline, making them unavailable to Scientists around the world. Dr Shi has said they were taken offline because of a computer hack, but 15 months later they are still unavailable. Did you ask to see these databases? Were they provided to you and, if not, why not? And what was their answer?” Peter?
Dr Peter Daszak
I’ll go first, Marion. Yeah, look, I asked the question in front of the whole team, both sides, while we were at the Institute, Wuhan Institute of Virology, about the so-called missing database, and what we were told by Shi Zhengli was that it had been – there had been hacking attempts on it, about 3,000 hacking attempts, and they took down this excel spreadsheet, data-based database. Absolutely reasonable. We did not ask to see the data, and, as you know, a lot of this work is work that’s being conducted with EcoHealth Alliance. I’m also part of those data, and, you know, we do basically know what’s in those databases. I shared – I gave a talk to both sides about the work we’ve done with Wuhan Institute of Virology and explained what’s there. There is no evidence of viruses closer to SARS-CoV-2 than RaTG13 in those databases, it’s as simple as that.
Emma Ross
Anybody else want to add?
Professor Marion Koopmans
No, but quickly those – I think that was – and we discussed that at length, the constant bombardment of hacks that they had, which really, you know, made them – you know, they had to shut down, and I think that’s, yeah, that’s also part of the picture.
Emma Ross
Okay. To wrap up, we’re low on time, but I’m going to try and keep it to time, I just want to, kind of, throw it forward to any lessons from this mission about studying the origins of an outbreak in the future, but also to pan out to zoonoses and what we can look forward to in the future, in terms of this happening again, and what you think needs the most attention, if we’re going to protect ourselves from this kind of threat in the future? So, whoever wants to come in on that, either lessons for doing missions, or lessons or, you know, the next pandemic or what this means for zoonosis and preventing the threat, or combating the threat. Marion, go ahead.
Professor Marion Koopmans
Yeah, so I think despite all the, you know, the turmoil now, this really needs to happen and should continue to happen and should become normal, and I think part of the, and I’ve said that also on other meetings, I think a good step would be if at the World Health Assembly it was discussed, why don’t we do
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this with every outbreak, as a routine, as a default, you get a team to review whatever you think happened, unless there really is agreement that that’s not necessary this time around, so that it becomes not a, sort of, a bit of a punishment, or insensitive, but make it routine. We have an outbreak in the Netherlands, bring in the experts, make that routine, I think that would help, and also if this – so this set up, I think doing joint studies is important. There is excellent Scientists all over the world, it’s – I don’t think it’s good practice to say come in, we come in and hand over everything you have, and we will let you know what our conclusions are, that is a different way of working. But having then budgets to develop those studies, so that they really become joint studies, that would also be a recommendation.
Emma Ross
David, do you want to come in on this? I know you’ve got strong feelings.
Professor David Heymann CBE
No, I would just come back to Marion and say how many countries do you think would allow a WHO team to come in and work with them?
Professor Marion Koopmans
Well, we’ve discussed that also in our team, if – well, we’ve had, in our country, a major bird flu outbreak, we have had Q fever, and I remember there was some mention from the ECDC then, what is it that you’re doing? I think it would not be welcomed very easily, because, yeah, it feels like people coming in and telling you you’re not doing a good job, so – and that’s why I think it’s – or, you know, go to the US CDC, let me – can we see, please, all your data about outbreak A, B or C, I don’t think that would be that easy. So, I think if we want to move beyond this sensitivity, let’s just make it routine, standard. That, to me, would be just a good step.
Dr Peter Daszak
Let me chime in on this. I think that, you know, there’s a – if you look at existential threats to our populations, our nations, our security, which pandemics clearly are, and compare what we do with others compared to this, we don’t forecast them well. We don’t put enough energy into forecasting pandemics and working out where the next one’s going to come from or what it might be, whereas we do that with hurricanes and typhoons and all the rest of it.
If you look at 9/11, prior to 9/11, the US looked at Al-Qaeda attacks as to something where we know roughly where they are, and we’ll send over the occasional attack to disrupt them. After 9/11, we put in place a mechanism to track every single phone call into the US and the minute there’s rumours on the web or on these phone calls of an attack, the network is disrupted prior to the attack. That’s the sort of change and shift in thinking we need for pandemics, I believe. We need to look at the rumours of future pandemics, and let’s look at wildlife and where wildlife are interacting with livestock and people and try and see what’s out there. Try to find out what threats are out there in wildlife that could emerge in future, work out where they are, work out who’s in the frontline of getting them, and disrupt that interface.
Emma Ross
And would that be a huge shift from where we are now? I mean, how much of that are we already doing?
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Dr Peter Daszak
Well, one of the things being done are small research projects, but it needs to be scaled up and built into systems, as Marion said, this should be routine. Why don’t outbreak investigation teams, at the very least, have a one health approach with Veterinarians and Ecologists as part of that? And some countries are doing that, some organisations are building that in, it needs to be standardised and we need to move proactive, so we’re working to pre-empt pandemics, that’s the strategy. That’s – that will give us an incredible return on investment.
Emma Ross
Okay, great, well, we’re at the hour, so I’m going to wrap up now and just for the audience, in case you haven’t looked in the ‘Q&A’, if you were looking for the report, the hope is that in about two weeks’ time it’ll be published, so look out for that. And I’m afraid that’s all we have time for today, but all of you, thank you so much for sharing a lot of insight and I think quite a nuanced discussion behind the scenes that I hope takes all of us a bit beyond the conversation to date. So, we’re really grateful to have had you on to bring this aspect to the discussion, and it’s really, really important to get into the nuances and move past some of the more rudimentary discussions that are going on. So, big thanks for coming, and thank you to the audience for tuning in and sticking with us, and that’s it for now, and David and I will be back, I’m not quite sure which one will be next, but look out for the next webinar. Okay, thank you very much and have a great rest of the day. Thanks, bye.