The Morning Jolt

World

Lessons We Didn’t Learn

People line up outside a drugstore to buy masks in Shanghai, China January 24, 2020. , (Aly Song/Reuters)

On the menu today: a giant scoop related to safety measures at the Wuhan Institute of Virology; the widely forgotten — or perhaps never-learned — lessons from the last SARS outbreak in 2002–2003; and one particularly ominous possible scenario.

2018 U.S. State Department Cable: The Wuhan Lab Doesn’t Have Enough Trained Technicians

All credit to Josh Rogin of the Washington Post, reporting one hell of an important scoop:

Two years before the novel coronavirus pandemic upended the world, U.S. Embassy officials visited a Chinese research facility in the city of Wuhan several times and sent two official warnings back to Washington about inadequate safety at the lab, which was conducting risky studies on coronaviruses from bats. The cables have fueled discussions inside the U.S. government about whether this or another Wuhan lab was the source of the virus — even though conclusive proof has yet to emerge.

In January 2018, the U.S. Embassy in Beijing took the unusual step of repeatedly sending U.S. science diplomats to the Wuhan Institute of Virology (WIV), which had in 2015 become China’s first laboratory to achieve the highest level of international bioresearch safety (known as BSL-4). WIV issued a news release in English about the last of these visits, which occurred on March 27, 2018. The U.S. delegation was led by Jamison Fouss, the consul general in Wuhan, and Rick Switzer, the embassy’s counselor of environment, science, technology and health. Last week, WIV erased that statement from its website, though it remains archived on the Internet.

What the U.S. officials learned during their visits concerned them so much that they dispatched two diplomatic cables categorized as Sensitive But Unclassified back to Washington. The cables warned about safety and management weaknesses at the WIV lab and proposed more attention and help. The first cable, which I obtained, also warns that the lab’s work on bat coronaviruses and their potential human transmission represented a risk of a new SARS-like pandemic.

“During interactions with scientists at the WIV laboratory, they noted the new lab has a serious shortage of appropriately trained technicians and investigators needed to safely operate this high-containment laboratory,” states the Jan. 19, 2018, cable, which was drafted by two officials from the embassy’s environment, science and health sections who met with the WIV scientists. (The State Department declined to comment on this and other details of the story.)

. . . The research was designed to prevent the next SARS-like pandemic by anticipating how it might emerge. But even in 2015, other scientists questioned whether Shi’s team was taking unnecessary risks.

What was I just writing about the prevalence of mistakes and accidents at even the best labs in the world? Please, let us dispense with two particularly unpersuasive arguments: “If this virus entered humans because of a lab accident, the Chinese government would tell us” and “The scientists at either of the Wuhan labs working on coronaviruses in bats are simply too diligent and professional to ever have an accident that could release a virus.”

Lessons from the Last SARS Outbreak

The original SARS — Severe Acute Respiratory Syndrome — also was traced back to horseshoe bats in China’s Yunnan Province. The average American probably doesn’t remember the first SARS outbreak much; maybe you remember actor Peter Sarsgaard hosting Saturday Night Live in 2006 and making a pretend commercial for “Peter Sarsgaard’s Sars Guards.” (“Normally I’d never try to take advantage of a terrible tragedy, but my name is Peter Sarsgaard; it was kind of a no-brainer.”)

The first outbreak was in China’s Guangdong Province, and — you’re going to want to sit down for this, because it’s going to shock you — the Chinese government initially denied the problem, tried to cover it up, lied about how fast SARS was spreading, ordered doctors to lie to the World Health Organization, barred a WHO team from visiting the sites of the outbreak, and made a bad situation much worse out of a blinding obsession with not “losing face.” (Fitting that this virus is being called “SARS-CoV-2,” huh? It really is a sequel that no one wanted and that’s worse than the original.)

The virus spread around Chinese hospitals in January 2003 and arrived in Hong Kong by February. (One of the many reasons SARS didn’t permeate the American consciousness as one might expect is that the virus became widely known right as the United States and its allies were preparing for the invasion of Iraq.) Like this virus, international travelers brought SARS to countries like Vietnam, Canada, Taiwan, Singapore, Thailand. By March, SARS was starting to infect people all over Asia.

The World Health Organization issued a global alert for a severe form of pneumonia of unknown origin in persons from China, Vietnam, and Hong Kong on . . . March 12. (That happens to be the day this year that WHO declared this coronavirus a pandemic.)

By April 1, the United States was withdrawing diplomats from consulates in regions where SARS was spreading. By April 22, the U.S. issued a travel warning for Toronto, Canada. But then something wonderful happened: All of the efforts to contain SARS seemed to work. By May 6, the CDC declared containment in the United States to be successful, and month by month, one country after another came off the travel warning list. By July 5, the World Health Organization declared the outbreak contained globally. By the end of the year, “WHO received reports of SARS from 29 countries and regions; 8,096 persons with probable SARS resulting in 774 deaths. In the United States, eight SARS infections were documented by laboratory testing and an additional 19 probable SARS infections were reported.” China announced one new case in December, the first in six months. In April of 2004, there were other small outbreaks in China. The last known cases were in May 2004; some of the final reported cases stemmed from two separate accidents in Chinese Institute of Virology in Beijing.

And that’s . . . when SARS pretty much disappeared. We haven’t seen any cases in about sixteen years. The virus, as far as we can tell, died out in the wild or is no longer in human beings.

The virus we’re currently battling appears to be less likely to kill you than original SARS. Unfortunately, it appears much more contagious — so a lot more people are catching it, and a lot more people are succumbing to it.

But If This Virus Doesn’t Just Burn Out or Disappear in a Year or Two . . .

In yesterday’s examination of the worst-case scenarios for this outbreak, I left one longer-term possibly out: the notion that SARS-CoV-2 becomes a recurring factor in our lives for years to come.

There’s precedent for a coronavirus becoming endemic in the human population. Actually, there are four of them: 229E, NL63, OC43 and HKU1. All four of these coronaviruses cause symptoms of the common cold, and infections are most often fairly mild.

“We do know about other coronaviruses, it’s not like this is a virus that’s completely out of a new category,” says Amesh Adalja, a senior scholar at the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security. “I think this will join those four other coronaviruses and have a similar pattern [of recurrence] after this first wave.”

As of right now, Adalja says, the novel coronavirus displays all the signs of sticking around. It’s widespread in the population, transmits from person to person easily and there’s no vaccine that could grant immunity ahead of an infection.

A virus’ mutation rate is another important factor in determining the severity of reappearances of an endemic virus. The flu is so pervasive because it mutates readily, swapping around the surface proteins that our immune systems rely on to recognize viruses.

“You can get a new flu infection every year because your antibodies are not necessarily as protective,” says Andrew Brouwer, a research scientist and epidemiological modeler also at the University of Michigan’s School of Public Health. “We don’t really know what that’s going to look like for this virus.”

Herd immunity protects people against the virus as it is, but it may not protect against a different version of the virus in the future. The question is how much the virus will change and how rapidly, and how much the “lessons” your body learns from fighting off one virus apply to future infections. We may need to be vaccinating to protect against variations of SARS-CoV-2 for many years to come.

Yesterday’s discussion of lab safety and accidents noted the different biocontainment levels for labs. This morning brings an argument about what level of safety should be required for research on SARS-CoV-2 that initially seems crazy but ultimately is logical. Right now, the U.S. Centers for Disease Control and Prevention want only labs that are BSL-3 or higher to be culturing the SARS-CoV-2 virus.

Glenn Rockman argues that if we want research on SARS-CoV-2 to move faster, we should allow labs built to handle less dangerous viruses and bacteria to get in on the act.

A trip to the grocery store now poses a much greater risk of SARS-CoV-2 infection than conducting vaccine research at a well-managed BSL-2 facility, where virus-handling occurs in a negative-pressure HEPA-filtered biosafety cabinet using a full complement of personal protective equipment. While the precautions in a BSL-2 facility aren’t, by definition, as extensive as BSL-3 precautions, BSL-2 facilities still use highly effective, institutionally engrained, federally regulated safeguards to avoid laboratory-acquired infections or accidental release of a pathogen into the environment.

The advantage is that BSL-2 research and manufacturing capacity is available in abundance compared to BSL-3 and BSL-4 facilities.

He’s got a point; the horse is already out of the barn. As of December 2016, the United States has eight BSL-4 laboratories and 221 BSL-3 laboratories, but 87 BSL-2 laboratories. That would be a lot of scientific research reinforcements to unleash against this virus.

ADDENDUM: All across the country, teachers and school administrators are trying to put together a way to teach kids without everyone gathering in a school — from Des Moines to San Diego to Oregon to Oklahoma to Texas. In my neck of the woods in Fairfax County, Va., distance learning begins in earnest today. For all the teachers out there who are trying their best and who have been consistently reaching out to students since school buildings were closed, thank you. Our nation’s children will feel better seeing you through a screen, but your presence in their lives can never really be replaced.

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