The covid-19 lab leak hypothesis: did the media fall victim to a misinformation campaign?
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1656 (Published 08 July 2021) Cite this as: BMJ 2021;374:n1656Read our latest coverage of the coronavirus pandemic
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Dear Editor,
The origin of SARS-CoV-2, the betacoronavirus agent responsible for COVID-19, is a hotly debated issue. Within such context, an “artificial origin hypothesis”, likely through laboratory recombination, was originally raised based upon the occurrence of a presumably unique insertion sequence, 1,378 bp-long, located in the middle of SARS-CoV-2 spike (S) glycoprotein gene, which did not match with those from other coronaviruses (James Lyons-Weiler, 2020, personal communication). Subsequent studies showed, however, that the aforementioned SARS-CoV-2 S gene sequence was largely available in coronaviruses from natural sources [1].
Notwithstanding the above, the SARS-CoV-2 laboratory origin hypothesis has recently gained additional interest, with the main driver justifying this assumption being represented by the so-called "gain of function" (GOF). This is a process resulting in the acquirement of new phenotypic characters, as a consequence of the manipulations of the viral genetic make-up artificially made in the laboratory. Within this scenario, there is a question I believe is of crucial relevance: is the "laboratory of virology" or, more precisely, was the "Institute of Virology of Wuhan" the site where SARS-CoV-2 originated, based upon a GOF-related process involving one or more "cousin" coronaviruses? And, still noteworthy, may a GOF-associated process also occur in nature, with one or more viral "genetic/molecular signatures" testifying its development (which would also apply to artificial/laboratory conditions)?
In this respect, while it should be duly underscored, on one side, that 14 years were needed to trace back the origin of the SARS-CoV epidemic from bats to humans (via an intermediate host, most likely represented by civets) [2], recent studies have found, on the other side, that a coronavirus (RmYN02) from bats living in Southern China might be more closely related to SARS-CoV-2 than a previously identified bat coronavirus (RATG13) [3].
Noteworthy, the SARS-CoV-2 genome is made of approximately 30,000 nucleotides, with each viral replication cycle implying the occurrence of an average of 1 mutation/10,000 bases. There are, of course, different types of mutations, some "silent", some "non-silent", some "disadvantageous" (against which "purifying, or negative selection" operates), some other ones "advantageous" (in favour of/toward which "Darwinian, or positive selection" operates). Just to make a long story short, following the aforementioned mutational events, SARS-CoV-2 could have originated under natural conditions from a coronavirus "ancestor" like the two aforementioned bat coronaviruses [3], sharing with it over 96% genetic homology. Further mutations of the SARS-CoV-2 genetic make-up could have led the virus to develop a growing number of "variants of concern" (VOC) and/or “variants of interest” (VOI) circulating in many Countries, both European and non-European, such as the "alfa" (formerly “English”, alias “B.1.1.7”), “beta” (formerly “South African”, alias “B.1.351”), "gamma" (formerly “Brazilian”, alias “P.1”), "delta”, “delta plus” and “kappa” (formerly “Indian”, alias “B.1.617.1”, “B.617.2” and “B.1.617.3”), alongside the more recently identified “lambda” (alias "C.37") and “mu” (alias "B.1.621") variants.
Among the SARS-CoV-2 VOC deserving special interest there is the one named “cluster 5”, which is characterized by the “Y453F” mutation within the “receptor-binding domain” (RBD) of the viral S glycoprotein. Indeed, differently from all the aforementioned (as well as from all the other hitherto characterized) VOC and VO, all of which developed in mankind, the “cluster 5” VOC emerged over one year ago in intensely bred mink from The Netherlands and Denmark, where approximately 17 million animals had to be killed as a consequence of the public health hazard posed by them. Once acquired from infected humans, in fact, SARS-CoV-2 was shown to evolve into the "cluster 5" variant inside the body of mink, which were additionally shown to “return” the mutated virus to humans [4]. The growing emergence of SARS-CoV-2 variants, now defined with the Greek alphabet letters, coupled with the progressively expanding list of SARS-CoV-2 susceptible species (under both natural and experimental conditions), as recently shown by white-tailed deer (Odocoileus virginianus) from Eastern USA [5], could represent a sort of “vicious circle” supporting, in its turn, the development of additional VOC and/or VOI of the virus [6], a number of which could partially escape - with special emphasis on the “delta” variant - the immunity conferred by SARS-CoV-2 infection and/or by the currently available anti-SARS-CoV-2 vaccines [7, 8]. How not to deem this a GOF-related phenomenon, in a similar fashion to the genetic mutations progressively acquired by the virus at the S glycoprotein RBD level, a number of which are known to render it more infectious [9]?
Interestingly enough, a naturally occurring case of infection by the “alfa” VOC of the virus has been recently documented in a domestic cat from North-Western Italy, which most likely caught the infection from a COVID-19-affected owner (Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, unpublished observations).
In the light of what is reported above, why not take into consideration the possibility of vaccinating (also) animals against SARS-CoV-2, with special emphasis on those living in close contact with humans and, overall, in intensely bred species, such as mink and pigs, or wild species with a marked social behaviour like white-tailed deer?
To this aim, an "evidence-based", coupled with an “holistic”, "One Health-based" approach, should be simultaneously adopted, provided that - as the dramatic SARS-CoV-2 pandemic reminds us - human, animal and environmental health are tightly and mutually linked to each other.
References
1) Hao, P.; Zhong, W.; Song, S.; Fan, S.; Li, X. Is SARS-CoV-2 originated from laboratory? A rebuttal to the claim of formation via laboratory recombination. Emerg. Microb. Infect. 2020, 9, 545-547. doi: 10.1080/22221751.2020.1738279.
2) Hu, B.; Zeng, L.P.; Yang, X.L.; Ge, X.Y.; Zhang, W.; Li, B.; Xie, J.Z.; Shen, X.R.; Zhang, Y.Z.; Wang, N., et al. Discovery of a rich gene pool of bat SARS-related coronaviruses provides new insights into the origin of SARS coronavirus. PLoS Pathog 2017, 13, e1006698. https://doi.org/10.1371/journal.ppat.1006698.
3) Maxmen, A.; Mallapaty, S. The COVID lab-leak hypothesis: what scientists do and don’t know. Nature 2021, 594, 313-315. doi: https://doi.org/10.1038/d41586-021-01529-3.
4) Di Guardo, G. Future trajectories of SARS-CoV-2 in animals. Vet. Rec. 2021, 188, 475. doi: 10.1002/vetr.663.
5) Mallapaty, S. The coronavirus is rife in common US deer. Nature 2021, Aug 02. doi: 10.1038/d41586-021-02110-8. Epub ahead of print.
6) Di Guardo, G. White-tailed deer, another SARS-CoV-2-susceptible species. BMJ 2021, September 08. https://www.bmj.com/content/374/bmj.n1734/rr-3.
7) Callaway, E.; Ledford, H. How to redesign COVID vaccines so they protect against variants. Nature 2021, 590, 15-16. doi: 10.1038/d41586-021-00241-6.
8) Lauring, A.S.; Hodcroft, E.B. Genetic variants of SARS-CoV-2: what do they mean? JAMA 2021, 325, 529-531. doi: 10.1001/jama.2020.27124.
9) Mansbach, R.A.; Chakraborty, S.; Nguyen, K.; Montefiori, D.C.; Korber, B.; Gnanakaran, S. The SARS-CoV-2 Spike variant D614G favors an open conformational state. Sci. Adv. 2021, 7, eabf3671. doi: 10.1126/sciadv.abf3671.
Competing interests: No competing interests
Dear Editor,
The BMJ’s publication of this article examining the “dramatic U turn” in coverage of the lab leak theory is welcomed. Responses to the article so far, however, reveal that this article may be helped in justifying its assertion that “the ‘lab leak’ scenario deserves serious investigation” by additional information that provides reason for suspecting a lab leak. There are a number of gestures to these reasons in the article, which, if examined more thoroughly, may prove helpful to this cause.
The article alludes to a number of coronavirus “experiments that altered the transmissibility of viruses” and to a “2015 paper on the creation of a hybrid version of a SARS virus, co-written by Shi”, but does not explicitly detail the contents of these experiments. The 2015 paper (https://www.nature.com/articles/nm.3985) used reverse genetics to generate a “chimeric virus expressing the spike of bat coronavirus SHC014 in a mouse-adapted SARS-CoV backbone”, which could “replicate efficiently in primary human airway cells.” The paper acknowledges U.S. government funding under the USAID Emerging Pandemic Threats program from EcoHealth Alliance. A 2016 study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936131/), listed on the National Institute of Health (NIH) Project Detail’s page for another U.S. government grant awarded to EcoHealth Alliance (https://reporter.nih.gov/search/GCBvbhJJPEOJ8Rp15r1W1A/project-details/9...), “developed [and then used] a fast and cost-effective method for reverse genetics of coronaviruses” at the Wuhan Institute of Virology (WIV). In fact, the abstract for this NIH funding grant to EcoHealth Alliance from the Project Detail's page specifies how one of the “three specific aims of this project” is to genetically manipulate coronaviruses to examine the possibility for animal to human transmission: “3. Test prediction of CoV inter-species transmission. Predict models of host range (i.e. emergence potential) will be tested experimentally using reverse genetics, pseudovirus and receptor binding assays, and virus infection experiments across a range of cell cultures from different species and humanized mice.”
There is also evidence of further research involving manipulation of coronaviruses at the WIV (that cannot be linked to EcoHealth). Vanity Fair has reported (https://www.vanityfair.com/news/2021/06/the-lab-leak-theory-inside-the-f...) that “Shi’s own comments to a science journal, and grant information available on a Chinese government database, suggest that in the past three years her team has tested two novel but undisclosed bat coronaviruses on humanized mice, to gauge their infectiousness.” Meanwhile, a U.S. State Department fact sheet (https://2017-2021.state.gov/fact-sheet-activity-at-the-wuhan-institute-o...) dated 15 January 2021 states that “The WIV has engaged in classified research, including laboratory experiments, on behalf of the Chinese military since at least 2017.” Vanity Fair has reported that one study submitted in April 2020, for which 11 of its 23 coauthors worked for the Chinese army medical research institute, tested “the susceptibility… of engineered mice with humanized lungs... to SARS-CoV-2.” The date of the publication was determined by American National Security Council officials to indicate that these mice must have been engineered in the summer of 2019, raising the question why had the Chinese military decided to engineer mice to test their susceptibility to a virus that was not known to exist?
The article notes the World Health Organisation’s (WHO) fact-finding mission “included Daszak on the team.” The WHO had invited the U.S. to recommend scientists for the mission. None of the three proposed were selected; the only representative selected from the U.S. was Daszak. The WHO mission proceeded to not examine the WIV’s database of 22,000 virus and samples. Daszak unquestioningly accepted Shi Zhengli’s assertion that they could not hand the data over because the “database… had been taken offline… due to hacking attempts during the pandemic”, despite the database being taken offline on 12th September 2019, several months prior to the beginning of the pandemic (https://www.vanityfair.com/news/2021/06/the-lab-leak-theory-inside-the-f... and https://2017-2021.state.gov/fact-sheet-activity-at-the-wuhan-institute-o...). Daszak explained “we did not need to see the data… a lot of this work has been conducted with EcoHealth Alliance… We do basically know what’s in those databases… simple as that.” Recently, the WHO has published proposals for further investigation, including “audits of relevant laboratories and research institutions operating in the area of the initial human cases identified in December 2019” (https://www.theguardian.com/world/2021/jul/16/who-chief-calls-for-audits...).
Lastly, the article explains “hundreds of lab accidences had happened in the US alone.” Concerns have also been raised about safety at the WIV specifically. Business Insider has reported (https://www.businessinsider.com/us-officials-raised-alarms-about-safety-...) that following visits to the WIV, US diplomats and scientists sent diplomatic cables in January 2018 expressing concern about a “serious shortage of appropriately trained technicians and investigators needed to safely operate this high-containment laboratory”, which “represented a risk of a new SARS-like pandemic.”
Competing interests: No competing interests
Dear Editor
Not an unlikely hypothesis in terms of human behaviour. Even in countries where there is freedom of speech and respect for human rights, can we doubt any organisation responsible for world wide death and disruption would try everything to cover it up?
Competing interests: No competing interests
Dear Editor,
The recent piece on the lab leak hypothesis did not provide much clarity for readers on the various arguments in the literature for the virus having a natural origin.
A quotation notes that “an accident ... is the opposite of a conspiracy”, but the conspiracy refers to the significant effort needed to cover up such an accident, which would most likely involve hundreds of people. Such an extraordinary claim demands extraordinary evidence.
The criticised WHO report described possible origins in terms of probabilities for good reason - because confirmation in science is difficult and takes time. It took until 2017 for the likely origin of the 2003 SARS virus to be found in bats. Since all known human coronaviruses have spilled over from animals, it is reasonable to assign a higher level of probability to this hypothesis in the absence of evidence to the contrary.
Negatives are famously impossible to prove – even if there were full transparency, there would still be complaints that it was not "full" if it did not support preconceived ideas. Limitations and supervision during these visits are no surprise - any government, including our own, would require this. Insufficient empathy is accorded to colleagues in China who likely feel that despite their openness, they are being unfairly demonised.
By treating two theories with wildly different likelihoods as equivalent, we risk normalising the idea that the lab leak hypothesis is equally valid, when no hard evidence for it has been produced. Not only could this fuel racial abuse, but it could also harm future international cooperation.
When the next pandemic emerges (as it will), we may find that we have destroyed much of the goodwill that is necessary to mount an effective global response.
Competing interests: No competing interests
Dear Editor,
We commend Thacker for writing this comprehensive review of the history of the Wuhan Lab Leak hypothesis and the BMJ for publishing it.
It makes for uncomfortable reading.
That a small group of scientists, with (apparently) hitherto undeclared links with the Wuhan Institute of Virology were able to prevent open-minded, critical analysis of the origins of SARS-CoV 2 for much of 2020 is regrettable.
Their actions to close down debate about a possible laboratory accident as a source of SARS-CoV 2 escaping into Wuhan city have seriously damaged the chances that we will ever find out the truth of what transpired in Wuhan in 2019.
We draw two key lessons from Thacker’s review.
Firstly, all scientific and medical journals should reflect on their declaration of interest policies for authors. They should carefully examine them to see if there are any loopholes which may allow authors to be less than fully transparent. They should not restrict the search for conflicts of interest to the purely financial.
Furthermore, scientific and medical journals might consider withdrawing articles if significant undeclared associations, financial and/or other interests come to light after publication. This would encourage those who would choose opacity to think twice.
Secondly, the prevailing “consensus” in 2020 that COVID-19 must have arisen from SARS-CoV 2 jumping the species barrier from e.g. an unknown Chinese bat into a human host to the exclusion of all other possibilities has lessons for us all.
One recalls a medical Grand Round at a London teaching hospital years ago where the theme was “Always challenge orthodoxy”. From time to time, or perhaps more often, it’s important for us all to think hard and critically about what we know, or in the case of the origin of SARS-CoV2, what we think we know.
References:
Thacker P D. The covid-19 lab leak hypothesis: did the media fall victim to a misinformation campaign? BMJ 2021; 374:n1656 doi: https://doi.org/10.1136/bmj.n1656
Competing interests: No competing interests
Dear Editors
The world, despite the ongoing conflict, turmoil and disasters (both natural and man-made), is at a precipice: there are serious concern that a 'rogue' nation holds the key to the current and potential human catastrophes many countries are undergoing.
Accusations with little supporting evidence flew in from many corners of the world, although it is obvious that only a few have made serious and ongoing efforst at undermining the regime that wields the political and military power of this country.
Investigators from various international organisations and agencies gain access to inspect facilities suspected to house these destructive assets, but no damning evidence was found nor any certain conclusion can be made from these visits (or rather one that all the scientists, including certain activists, can agree to anyway).
Then, the accusing states score a scoop: they have sworn statements from a sole asylum-seeking whistleblower, with apparent credentials and access, that indeed the accused regime was responsible for activities whose only purpose is to cause mass human suffering.
The evidence was tabled at an international forum, the merits of these proof were debated. The confidence of the accusers of what appears to be extensive inside knowledge of the malicious research undertaken, sway a few countries to participate in a policing action without a mandate from the international community.
And that is how Gulf War II (2003 invasion of Iraq) was initiated by a coalition of the willing (few), based on speculation and false evidence largely based on intelligence from an Iraqi informant/asylum-seeker, Rafid Ahmed Alwan al-Janabi (codenamed Curveball) (ref 1), apparently described by the CIA in 2007 as "a guy trying to get his green card essentially, in Germany, and playing the system for what it was worth" after the Coalition having successfully conducted a short but decisive war (but created an unstable social and secular power vacuum) was unable to find the fabled massive cache of weapons of mass destruction.
I am sure Mr Thacker is aware of the irony of his article seeming to be about the conspiracy theory against the conspiracy theories of lab leak hypothesis focussed on the research activities at Wuhan Institute of Virology.
If activities to counter negative and false narrative to oneself (by defending one's reputation, persuading others of their virtue and track record and pointing out the flaws of the accusations as well as outright discrediting the ardent accusers) is conspiring, that we have to submit that the organised methodical response by a state to counter any negative allegation can, by default, be considered a conspiracy.
“How on earth can I offer up evidence for something where there is no evidence?” said Wuhan virologist Dr. Shi Zhengli during the brief, unscheduled conversation (or "interview" as claimed by some media) when paparazzi reporter called her via her "cellphone" apparently unsolicited (ref 2).
This reminds me of the story attributed to Lyndon Johnson "about a politician who was in a neck-and-neck race with a rival and had come up with some trick to turn the election. In a moment of inspiration he told his campaign manager, “I’ve got it. We will accuse him of having sexual relations with pigs.” The campaign manager turned white and replied, “We can’t do that. It isn’t true.”
“I know it,” the politician replied, “but I want to hear him deny it.” (ref 3)
There are concerns that the secrecy and limited access to the Wuhan institute facilities and lab activities impeded adequate investigate and that this gives credence to the lab leak theory.
As much as there is some utopian ideal that if you have got nothing to hide, then you should not be afraid of submitting to investigations and unfetted search, in the end we need to understand that scientists work in a competitive field and are in constant fear that their work and ideas will be stolen, and that someone out there is going to "get there first" with a publication in a high impact journal.
If any readers have any reservations submitting their computers and mobile devices to law enforcement forces' investigating powers under the Official Secrets Act, perhaps they would understand the concerns of lab scientists when WHO investigators (some competing scientists themselves) are looking around a highly dangerous and secure Biosafety level 4 facility with limited orientation and adjustment, in a hurry to look for evidence supporting accusations that the Chinese scientists believe are unfounded.
Fellow readers should be reminded that the onus on the accusers is to provide the good evidence with the allegations, from which the accused can mount a defense. That is natural justice as we know it.
I do not believe Mr Thacker's piece contributes anything to advance those allegations of a lab leak from what we already know (and have discounted) so far.
Reference:
1. https://en.wikipedia.org/wiki/Curveball_(informant)
2. https://www.sbs.com.au/news/shi-zhengli-a-top-virologist-in-wuhan-speaks...
3. https://www.barrypopik.com/index.php/new_york_city/entry/i_know_its_not_...
Competing interests: No competing interests
Dear Editor,
Sadly, it seems that the debate on the origin of the Sars-Cov2-19 pandemic is being conducted mainly in the world of journalism with all its varied perspectives, biases and political leanings. This article adds to the "origin mystery", but as usual adds little to the evidence, apart from what is essentially hearsay.
Full co-operation and transparency from China is as unlikely to be offered as it would be from Bioscecure labs elsewhere--for instance, the US protects the identity of intensive pig farmers whose intensive animal rearing conditions lead to new influenza variants. Secrecy is not just a Chinese phenomenon.
Given this, hard evidence is unlikely to emerge, and the 'debate' will roll on until that is, like SARS, the source is found in bats or intermediate hosts - at that point the argument is over.
My own leaning is towards a zoonotic origin. My reasoning is that the destruction of the natural world, pressure on habitats, and the eating of wildlife represent a perfect recipe for pandemic creation and have led to HIV, Ebola, SARS, MERS, Hendra, Nipha and countless other human infections. Why not Covid19?
Well, a simple lab accident may well be a convenient scapegoat to deflect attention from the harsh lessons we have to learn, and allow us to avoid the connections between climate and habitat destruction and our own globalised habits which are creating the heat dome in North America as well as being behind the pandemic chaos. These are not warnings, they are consequences.
Blaming a lab accident is the easy way out of this, yet addressing the harsh reality of what we are doing to this planet is our ethical, biological, and, in my case, grand-paternal duty.
Let's not get distracted from this.
Competing interests: No competing interests
Dear Editor
This article on the COVID-19 origin is probable the most important published by the BMJ in many decades. Not only is there strong evidence of a leak being the cause, that this Chinese state virology Institute was actively augmenting corona viruses, and that the WHO had warned about such a leak 2 months before the pandemic, but even worse and arguably more importantly, that the western scientific and medical establishment helped to suppress the story and investigation! The Lancet, Scientific American, Nature, Science, along with so-called fact checking websites all were complicit in labelling the lab leak as a conspiracy theory and attacking those who held contradictory opinions to the 'consensus'.
I congratulate the BMJ on its willingness to stand up for truth on this issue. Science is based on an objective seeking of truth through reason. It must never be hijacked by political or other subjective or partisan aims, which unfortunately it has been on this and many other politically charged topics (some of which the BMJ is also complicit).
Gordon Gregory FRCS
Competing interests: No competing interests
Dear Editor
In his sobering article about the misinformation campaign directed against the highly plausible idea that SARS-CoV-2 may have originated in a lab in Wuhan (1), Paul Thacker writes that China notified the WHO on 31 December 2019 of cases of pneumonia of unknown aetiology in Wuhan City.
This was not the case (2,3). It was Taiwan that on that date alerted WHO to the risk of human-to-human transmission of the new virus, but WHO did not pass on the concern to other countries (4). China has ensured that Taiwan is not a member of WHO, and WHO’s cozy relationship with China was criticized, particularly when WHO overly praised China’s handling of the coronavirus outbreak despite the fact that China initially covered it up (3).
It is highly likely that SARS-CoV-2 escaped from the Wuhan Institute of Virology because of sloppy safety procedures (5). It is also likely that the virus was fabricated on purpose to make it dangerous to humans as part of the so-called gain-of-function research at the institute (5).
1 Thacker P. The covid-19 lab leak hypothesis: did the media fall victim to a misinformation campaign? BMJ 2021;374:n1656.
2 Gøtzsche PC. Vaccines: truth, lies, and controversy. New York: Skyhorse; 2021.
3 Davidson H. Chinese inquiry exonerates Coronavirus whistleblower doctor. The Guardian 2020; Mar 20.
4 Riordan P, Manson K, Hille K, Cookson C. Taiwan says WHO failed to act on coronavirus transmission warning. Financial Times 2020; Mar 20.
5 Gøtzsche PC. Made in China: the coronavirus that killed millions of people. Institute for Scientific Freedom 2021; May 19.
Competing interests: No competing interests
Origins of SARS-CoV-2: Communication of the weight of evidence is key
Dear Editor
Whilst all hypotheses must be considered when investigating the origins of SARS-CoV-2, the absence of any indication of the current weight of evidence for and against a laboratory origin hypothesis in this recent article (1) risks thwarting any consolidated action on the prevention of future pandemics.
We draw your attention to a crucial, peer-reviewed paper: ‘The origins of SARS-CoV-2: A critical review’ (2). This paper explores evidence for both a zoonotic origin and a laboratory origin of SARS-CoV-2. It concludes: ‘There is currently no evidence that SARS-CoV-2 has a laboratory origin’ (2).
Epidemiological evidence cited in this paper reveals Huanan Market as ‘an early and major epicentre of SARS-CoV-2’ (3) with ‘no epidemiological link to any other locality in Wuhan’ (2). No cases were reported related to laboratory staff at the Wuhan Institute of Virology (WIV), and all staff working under Dr Shi Zhengli at WIV were reported as seronegative to SARS-CoV-2 in March 2020 (3). Furthermore, thousands of live wild animals, known to be susceptible to SARS-CoV-2, were traded in markets in Wuhan, including Huanan, during 2019 (4) and environmental samples taken in Huanan market following its closure were positive for SARS-CoV-2 (3).
The authors also emphasise that SARS-CoV-2 contains no genetic markers pertaining to any prior laboratory experimentation (5), nor does any evidence exist of the presence of SARS-CoV-2, or a SARS-CoV-2 precursor, in the WIV (2). There is, however, emerging evidence (currently in pre-print form) to show sequences very similar (only one or two amino acids in difference) to early strains of SARS-CoV-2 circulating in bat populations (6) This not only supports a zoonotic origin hypothesis, but also highlights the very real threat of future pandemics. After all, 70% of all emerging infectious diseases have zoonotic origins (7), including every prior coronavirus (2)
In an era of unprecedented anthropogenic planetary change, extensive communication to medical professionals of all the scientific facts surrounding the origins of SARS-CoV-2 is vital if we are to advocate for the transformation needed to ensure prevention of future pandemics.
References
1. Thacker P.D. The covid-19 lab leak hypothesis: did the media fall victim to a misinformation campaign?BMJ 2021;374:n1656. doi:10.1136/bmj.n1656. pmid:34244293
2. Holmes E.C, Goldstein S.A, Rasmussen A.L, et al. The Origins of SARS-CoV-2: A critical review. Cell 2021.184(19):4848-4856.
3. World Health Organisation. WHO-Covened Global Study of Origins of SARS-CoV-2:China Part [internet] 2021 available from: https://www.who.int/publications/i/item/who-convened-global-study-of-ori... CITED IN Holmes E.C, Goldstein S.A, Rasmussen A.L, et al. The Origins of SARS-CoV-2: A critical review. Cell 2021.184(19):4848-4856.
4. Xiao X, Newmann C., Buesching C.D., Macdonald D.W and Zhoue Z-M. Animal sales from Wuhan wet markets immediately prior to the COVID-19 pandemic Sci. Rep. 2021. 11. 11898 CITED IN Holmes E.C, Goldstein S.A, Rasmussen A.L, et al. The Origins of SARS-CoV-2: A critical review. Cell 2021.184(19):4848-4856.
5. Anderson K.G., Rambaut A., Lipkin W.I., Holmes E.C and Garry R.F. The proximal origin of SARS-CoV-2. Nat. Med 2020. 26: 450-452 CITED IN Holmes E.C, Goldstein S.A, Rasmussen A.L, et al. The Origins of SARS-CoV-2: A critical review. Cell 2021.184(19):4848-4856.
6. Temmam S., Vongphayloth K., Salazar E.B. et al Coronaviruses with a SARS-CoV-2-like receptor-binding domain allowing ACE2-mediated entry into human cells isolated from bats of Indochinese peninsula. In Review. 2021
DOI: 10.21203/rs.3.rs-871965/v1
7. Jones K. E. et al. Global trends in emerging infectious diseases. Nature 2008 451:990-993, doi:10.1038/nature06536 CITED IN IPBES (2020) Workshop Report on Biodiversity and Pandemics of the Intergovernmental Platform on Biodiversity and Ecosystem Services. Daszak, P., Amuasi, J., das Neves, C. G.,et al., IPBES secretariat, Bonn, Germany, DOI:10.5281/zenodo.4147317.
Competing interests: No competing interests