WHO Experts Investigating Mysterious Origins Of SARS-CoV2 Virus ‘Will’ Visit Wuhan, China – But No Date Set Disease Surveillance 27/11/2020 • Elaine Ruth Fletcher Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Dr Tedros Adhanom Ghebreyesus, WHO Director-General. In a politically charged series of exchanges at a Friday press briefing, World Health Organization officials pushed back against queries by a representative of China’s state-controlled CCTV, asking about whether the SARS-CoV2 virus discovered in Wuhan, China in December of 2019 could have been circulating in humans “outside of China before the outbreak in Wuhan, but without being noticed.” “One thing that has to be clear is the study will start from China, Wuhan, where the first report came,” said WHO Director General Dr Tedros Adhanom Ghebreyesus at the press briefing. “And then from there, based on the findings, we can go anywhere. So I think it’s better to really underline that.” Mike Ryan, WHO Health Emergencies Executive Director, did not directly rule out the possibility that the virus could have been circulating somewhere else in the world among animal populations – he said that the evidence of its first presence in humans led to China: “It is clear from a public health perspective that you start your investigation from the place where the cases first emerge,” said Ryan, recalling that Chinese clinicians had first picked up the cluster of acute pneumonia cases in the city of 10 million people. “There was a link to the market market and it triggered in their minds a suspicion, and they reported it to the authorities. Dr. Michael Ryan, WHO Executive Director of Health Emergencies “So I think it’s highly speculative for us to say that the disease did not emerge in China. What we do know is the first clusters of human cases that were detected, were in Wuhan and China, there was a massive response to containing that disease there. And we look forward to working with our Chinese scientific colleagues to understand better the origins of the virus within China or beyond China, wherever that leads,” said Ryan. While an international WHO committee of experts mandated to investigate the big questions over the virus’s murky origins has now been named, and even held initial virtual meetings with colleagues in China – no date for any visit by the group to Wuhan, China has yet been set. WHO insiders have said that securing Chinese cooperation for a genuine fact-finding mission has been an uphill battle, despite the pledges of cooperation that have been publicly made, and repeated. Speaking at Friday’s press conference, WHO officials deferred yet again from setting a date, affirming only that the group will indeed visit Wuhan at some time in the future. “Yes, it’s correct, it will go to Wuhan, it will travel to Wuhan, thank you,” said Dr Tedros, briefly in response to another query by the Japan-based media outlet, NHK. Wuhan, China Patient ”Zero” and Geopolitics The origins of the virus in China, while linked to a Wuhan market where wild animals were slaughtered and sold for traditional foods,has never been pinned down completely through the identification of a “patient zero” who was the first to become infected from an animal source. The virus is thought to have emerged among bats; coronaviruses circulate in bat populations in rural regions of the country. Although there could have been other intermediary animals involved as well, including ones transported to the Wuhan market by traders. However, no clear animal to human transmission chain has so far been identified, and the heavy official Chinese government controls over research, travel and media have left many avenues closed to international sleuths. And after months in which outgoing US President Donald Trump repeatedly blamed China for the pandemic’s emergence, constantly referring to SARS-COV2 as the “China virus”, the issue of the virus’s origins has become even more politically charged, with Chinese government officials and media hitting back with the circulation of theories suggesting that maybe the virus lept the animal-human barrier somewhere else, outside of China. At the Friday briefing, WHO officials acknowledge that there is, in fact, evidence from Italian sewage and blood samples that human carriers of the virus may have been moving around the region, which has heavy business exchanges with China, as early as autumn, 2019. Maria Van Kerkhove, WHO technical lead for the WHO Health Emergencies team, referred to a recent studies at Milan’s National Cancer Institute (INT), which found traces of the SARS-CoV2 virus RNA in some peoples’ blood samples as early as September. Another study found traces in sewage in Milan and Turin. But insofar as the SARS-COV-2 family of viruses have never been reported to circulate in European animal populations prior to the pandemic, experts still conclude that any silent human carriers in Italy either brought the virus back with them from China – or were exposed to someone else who had traveled back and forth. Bats are are reservoir for cornaviruses that circulate in nature “There is one study that was published very recently, looking at serological samples from Italy, at a cancer screening institute in the fall, and they found serum positive samples in September,” Van Kerkhove said. “We reached out to these reserachers and they have generously offered to work with us and to colaborate with us on some further studies looking at those samples. “But as Mike has pointed out, the studies need to begin where the first cases were detected in Wuhan, where those first casese were detected in December,” she concluded. At a World Health Assembly (WHA) meeting in May, WHO member states unanimously agreed to mandate a team of international experts to identify “the zoonotic source of the virus and the route of introduction to the human population”. Following that, WHO sent an advance team to China in July to pave the way for a visit by the expert group, but progress on an actual visit stalled after that. Asked why at a media briefing on Monday, Kerkhove would say only that “the international team will travel to China”, and that it “is being discussed amongst the international team and the Chinese counterparts. And that will be arranged in due time”. An initial virtual meeting between the international and Chinese teams took place in October. Following that, WHO published outlines of a Phase 1 and Phase 2 study for the virus origins investigation. Just this week, WHO finally released the names of the experts who have been assigned to the delicate task of the virus hunt. Peter Daszak, President of EcoHealth Alliance They include prominent public health, animal health and virology experts from Australia, Denmark, Great Britain, Germany, Japan, Netherlands, Russia, Japan, Qatar, Viet Nam and the USA, including Marion Koopmans, who is leading research into the Dutch outbreak on mink farms and John Watson, former UK deputy chief medical officer. The team also includes Peter Daszak, a prominent British zoologist and researcher into bat coronaviruses in southeastern China, who is also president of the US Ecohealth Alliance. He holds the double hat as head of an independent Lancet’s COVID-19 Commission Task Force, which is also looking into the virus origins. At a November session of the WHA, Garrett Grigsby, deputy director of the US Department of Health and Human Services, charged that the investigation team’s terms of reference were “not negotiated in a transparent way with all WHO member states” and were inconsistent with the original WHA mandate, adding, “Understanding the origins of COVID-19 through a transparent and inclusive investigation is what must be done to meet the mandate.” WHO officials have said that they are regularly consulting with the missions of other governments in Geneva, and that the study process and findings will be transmitted transparently. Behind the scenes there is pressure on WHO to also push harder on the Chinese government – but whether this is out of deference to Beijing or a realistic assessment that it will not achieve anything, Dr Tedros and have team have resisted doing that. High Tech Freezer Solutions Could Make Even Pfizer Vaccine Feasible In Africa Katherine O’Brien, Director WHO Vaccines, Immunizations and Biologicals At the briefing, WHO officials also said that high-tech freezer solutions could make it feasible to even distribute COVID-19 vaccines like Pfizer’s mRNA candidate, which requires ultra-cold storage – at least in the central health facilities of developing countries. That could help ease the rollout of much-needed vaccines to vulnerable groups like health care workers, as soon as regulatory approval is obtained, said WHO’s Katherine O’Brien, speaking at the WHO press briefing. However, the experts also acknowledged that another up and coming vaccine, produced by AstraZeneca, and which can be preserved in normal refrigerator conditions, will be more practical for widespread rollout – if it wins approval soon. Their remarks echoed comments made earlier this week by WHO African regional officials. “We do have experience in a number of countries, specifically in Africa, being able to deploy a vaccine with that ultra cold chain requirement,” said O’Brien, referring to past experiences managing Ebola vaccines. “So as we anticipate the use of the Pfizer vaccine, the intention is certainly to be able to use it, along with other vaccines because no one vaccine is going to have adequate supply, nor will any one vaccine necessarily have suitable operational characteristics to meet all of the needs. O’Brien noted that Pfizer has already developed a special shipping container for its vaccine, that can maintain its stability for 101-15 days, and despite the overall ultra-cold requirement of -70 C, the vaccine can in fact be kept in a normal vaccine refrigerator for up to 5 days prior to its final use. Pfizer’s request for emergency use approval by the United States Food and Drug Administration will be reviewed on 10 December, and there is widespread expectation among US experts that the vaccine could even be approved the next day – making it the first to actually hit the market for distribution even before the end of the year. However, along with that, WHO’s Dr Tedros stressed once more that urgent funds are still needed to finance the massive procurement of billions of vaccine doses for low- and middle-income countries that cannot afford to purchase the vaccines themselves – and particularly not at the high-end prices of US$ 25-US$ 30 per dose (for a two dose shot) that is likely to be the benchmark in Europe and the United States for the cutting edge mRNA vaccines developed by Pfizer and Moderna. In comparison, AstraZeneca’s vaccine, which relies upon a less expensive adenovirus delivery platform, long been used in vaccine development and manufacture, is to be sold at the no-profit levels of just US$ 3 dollars a dose – or about US$ 6 in total. -James Hacker contributed to this story. Image Credits: Arend Kuester/Flickr, R Santos/HP Watch, Wikipedia , Shutterstock . Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.