By Chan Kung and He Jun*
During the Spring Festival in 2020, the Wuhan pneumonia epidemic caused by a new coronavirus infection raged in China and infected several other countries and regions. As of midnight January 26, a total of 2,744 confirmed cases were reported in 30 provinces (autonomous regions, municipalities) in mainland China and there were 461 severe cases and 80 death cases. Facing a large-scale infectious disease epidemic, it is extremely important to scientifically determine the source of the epidemic, the mode of transmission and the route of transmission as soon as possible as it is extremely crucial to control and prevent the epidemic. This is an important basis for determining prevention measures, organization mobilization, and system construction in the next step.
In the early stages of responding to the new coronavirus pneumonia in Wuhan, a considerable amount of effort was devoted to identifying the “source” of the epidemic. It is generally believed that the source of “Wuhan Pneumonia” is the Huanan Seafood Wholesale Market, because most of the first large-scale outbreak of unknown pneumonia cases came from this market. Wuhan City and the National Health and Medical Commission all held this view. At the end of December last year, the expert group of the National Health and Medical Commission also focused on the market. Since then, Academician Zhong Nanshan, the leader of the expert group with great influence on public opinion, has determined that the source of the virus outbreak may be Huanan Seafood Wholesale Market and the source of the new coronavirus is likely to be wild animals.
Wuhan Mayor Zhou Xianwang also recognized the market as the source of the outbreak when reflecting on the epidemic situation and said that the existence of this market serves as a heavy lesson, “worthy to be considered.” Public opinion reports show that the market has become the most relevant word related to “Wuhan Pneumonia”.
In contrast to these popular opinions, ANBOUND’s information analysis shows that the Huanan Seafood Wholesale Market is a concentrated place for the outbreak of this novel coronavirus pneumonia epidemic. However, whether this market is the real “source” of the epidemic is yet to be determined and even at the current stage, there are still completely opposite conclusions.
The qualitative issue for this “source” is of great importance. If the judgment is wrong, it may lead to deviations in the work direction and focus and even delay the timing of epidemic prevention. In our opinion, judging whether the market is the “source” of the pneumonia epidemic is a prudent reasoning and analysis process. It needs direct evidence that can be scientifically and logically supported. Certainly we cannot rely on non-scientific inferences with flaws in evidence or logic, let alone relying on speculation derived from some people, experts or administrative agencies.
From the perspective of analyzing the logical evidence chain, first, so far no novel coronavirus has been directly tested from the commodities in the market. The China Centers for Disease Control and Prevention (CDC) also only acknowledged that “the new coronavirus was successfully isolated from environmental samples” and “confirmed that there are a large number of new coronaviruses 2019-nCoV in the Huanan Seafood Wholesale Market environment”. But where does the novel coronavirus, isolated in environmental samples, come from ? What exactly is the carrier ? Obviously, the environment and the carrier cannot be confused and medical experts cannot give an answer to this. Samples in the seafood market environment may be contaminated and it can only show the relationship between the environment and the virus, it cannot represent the relationship between the carrier and the virus. It is not direct evidence of “source”.
The reason is simple. If a patient is at home, then a lot of virus samples can be found in the home environment. It cannot be said that a large number of such patient families in Wuhan are the “source”. By extension, the Huanan Seafood Wholesale Market in Wuhan cannot be identified as the “source”.
Second, we must take a cautious look at falsified results in scientific analysis. If it is assumed that the Huanan Seafood Wholesale Market is the “source” and it is a very large-scale wholesale market in Wuhan, located at the upper end of the entire Wuhan wholesale business system, with a lot of travelling people and goods. Then on the chain of evidence, if the source of the virus is in this place, then the virus will definitely appear in other markets with wholesale seafood or wild animals. The incidence of “Wuhan Pneumonia” will inevitably be concentrated in multiple commercial outlet groups downstream of the directly related system.
The problem is that this has not happened and so far no pneumonia-like cases have been found in other area directly related to Wuhan. Therefore, from this falsification process, we can see that the Huanan Seafood Wholesale Market is likely to be a concentrated outbreak point of viruses caused by a large number of people, rather than the “source”. Obviously, determining the “source” is a big deal and we must carefully determine the nature of the available evidence. The Huanan Seafood Wholesale Market, which has now become “international well-known” due to the spread of public opinion, requires prudent, objective and scientific justification.
Third, from the perspective of infectious diseases, after the occurrence of new diseases, at least four major questions must be answered: What is the pathogen? How do pathogens cause disease? Where does the pathogen come from? How should the disease be treated? The first two questions have been answered. The medical department has isolated the novel coronavirus and obtained the entire genome sequence of the virus. But it got stuck on the third issue of the clue chain, that is, where the pathogen came from has not been solved.
Although it is suspectable that the virus may come from illegally trafficked wild animals, this is only a deferred guess based on classic book theory. So far, in the products sold and traded in Huanan Seafood Wholesale Market, no virus has been directly separated, no virus has been found, no direct product testing evidence and the allegation that the market being the “source” is not supported at all. As the Huanan Seafood Wholesale Market has been “cleaned”, hence it is difficult for the experts of the investigation team to conduct “re-examination”, yet even so, the existing technical conditions can be obtained at the micro-site of the commodity market leading to the discovery of the virus. And this kind of discovery must also be consistent with the virus discovery in the logistics link and the source of goods, so that the chain of evidence can be considered complete, reliable and effective in order to support the claim that the Huanan Seafood Wholesale Market is the “source”.
From the perspective of public policy analysis, the pursuit of scientific analysis for microcosm and integrity is not only to ensure the reliability and effectiveness of the evidence chain. This professional scientific exploration will also reflect the path of virus transmission. Locking down the true carriers of the virus has cleared the accusations that certain animals being the carriers.
Fourth, in fact, the simplest and most direct evidence is derived from on-site information. The direct sources of information from the Huanan Seafood Wholesale Market indicate that the earliest infected persons were fish and shrimp vendors and dried fruit vendors, not wild animal vendors. In addition, some research papers both in China and abroad also show that the first case was probably not originated from the Huanan Seafood Wholesale Market.
In fact, so far, there is no clear evidence that Wuhan Pneumonia patients in the Huanan Seafood Wholesale Market in Wuhan are the earliest people infected with Wuhan pneumonia. On the contrary, it is highly probable that the appearance and wandering of the earliest batch of virus carriers in Huanan Seafood Wholesale Market led to the high virus concentration in the space of the market. The merchants also operate on fixed booths, which has led to the concentrated infection of “Wuhan Pneumonia” in the market.
From the comprehensive analysis logic, it is obvious that the conclusion of the evidence analysis showing that the Huanan Seafood Wholesale Market being regarded as the source of “Wuhan pneumonia” still has a lot of uncertainty at least at this stage. It is more likely that the high concentration of novel coronavirus in the air in the market is caused by the dense crowds and environmental conditions that do not meet the standards of modern commercial place. The merchants in the market are fixed-point operations, unable to move and the lax conditions for virus carriers to enter and wander around make the merchants a susceptible group to be infected. Eventually, the market became the first concentrated outbreak of “Wuhan Pneumonia”. Likewise, if a virus carrier entered a movie theater and as a result, infected many people, but it cannot be concluded that the movie theater is the source of the virus. This movie theater is actually just a location of concentrated outbreak.
This conclusion is contrary to the current direction of domestic and international public opinion. Of course, it is also a subversive conclusion in determining the pathogen and the environment. So how should we treat some of the so-called scientific arguments contrary to this conclusion?
First, the international medical journal the Lancet recently published a Chinese expert’s paper on the study of the novel coronaviruses in 2019. The study analyzed the first 41 confirmed cases of infection with the novel coronavirus admitted to Wuhan hospitals between December 16, 2019 and January 2, 2020 and found that 66% of early infected victims had visited the Huanan Seafood Wholesale Market. In fact, this conclusion is obviously one related to epidemics and behaviour. It is a probabilistic suspicion of the virus site and should be used to guide the direction of the virus test, rather than rushing to judge the “source”.
Second, the CDC discovered in the virus traceability study that the institute first obtained 585 environmental samples from the Huanan Seafood Wholesale Market. (515 environmental samples were collected on January 1, 2020 and 70 samples were collected again on January 12, 2020). PCR test results showed that 33 of the specimens were tested positive for the novel coronavirus. These positive samples were distributed in 22 stalls and 1 garbage truck in the market, of which 93.9% (31/33) positive specimens were distributed in the western section where wild animals were sold in the Huanan Seafood Wholesale Market. The CDC carried out virus isolation on samples that tested positive for nucleic acids and successfully isolated novel coronaviruses from environmental samples, further confirming the existence of a large number of novel coronaviruses 2019-nCoV in the Huanan Seafood Wholesale Market environment.
This seemingly “irrefutable proof” conclusion has actually emphasized that the virus sample is only derived from the environment, but there are obvious flaws in the evaluation of the conclusion and the impact of actual public opinion, ignoring the understanding of the market environment and system, equating the environmental location to the “source of the virus”. If judged according to such information and knowledge chains, there may still be the possibility that thousands of households are the “source” in Wuhan.
Judging from the process of this Huanan Seafood Wholesale Market analysis case, the prevention and control of “Wuhan Pneumonia”, especially the policy decision, has obvious practical significance. The reason that ANBOUND’s continuous focus on the source of the pneumonia epidemic is that it is related to the public policy direction and key issues of the epidemic prevention and control. We believe that science is science. Science must be objective, it must have direct evidence to prove it and it must have a complete evidence chain that exists objectively to form a conclusion. Only by clarifying these points and priorities can we stop the real “source” of the virus and stop the deterioration and spread of the epidemic. From the perspective of public policy on disease control, perhaps it should be said that finding the “source” of the virus is not the most important thing now. Public policy and the release of public health and health resources should focus more on the host of the virus and the relationship between virus transmission. This is the most important thing at this stage, and it is also an important manifestation of the governance capacity.
*Founder of Anbound Think Tank in 1993, Chan Kung is now ANBOUND Chief Researcher. Chan Kung is one of China’s renowned experts in information analysis. Most of Chan Kung’s outstanding academic research activities are in economic information analysis, particularly in the area of public policy.
*He Jun is a master in the Institute for the History of Natural Sciences, Chinese Academy of Sciences, majoring in intellectual history of science and is a senior researcher at Anbound Consulting, an independent think tank with headquarters in Beijing. Established in 1993, Anbound specializes in public policy research.