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Pneumonia outbreak: ambiguous "Patient Zero" and virus source dispute
Wang Yiqing
BBC Chinese
February 18, 2020
China is working to curb the spread of the new coronavirus pneumonia, but where exactly the outbreak has started is still foggy. A doctor who was involved in treating the first new crown patient currently known to the public told the BBC that the patient was a patient with cerebral infarction in his 70s at home.
This is the first time that information about the early patient has been made public. He is believed to have developed the disease on December 1st, almost a week earlier than the patient previously reported by Wuhan officials on December 8th. It is worth noting that he has no history of exposure to the South China seafood market.
The wildlife trade in the South China Seafood Market in Wuhan has been suspected to have been the culprit for the epidemic, but the experience of the old man is challenging that conclusion. Scholars and netizens have questioned whether the virus has other potential sources, including whether it may be related to Wuhan Virus Research Institute.
Earliest known patient
The new outbreak of coronavirus pneumonia in Wuhan, which has infected more than 70,000 people and killed nearly 2,000 people in China, remains unclear as to how the virus initially crossed the species barrier and transmitted from animals to people. The key to understanding the virus's path of transmission is the identity of the first patient and how he became infected.
The Wuhan Municipal Health and Health Commission stated in a notification that the onset of the first case of new coronary pneumonia was December 8 last year, but an international authoritative medical journal "The Lancet" published on January 24 by A thesis written by Huang Chaolin and other deputy directors of Wuhan Jinyintan Hospital, who admitted to treating patients with new coronary pneumonia, pushed the first patient's onset time to December 1. The paper was written by nearly 30 researchers in Chinese medical institutions, and a considerable number of them are working in the field of treating patients with new crowns.
Dr. Wenjuan Wu, director of the Intensive Care Unit (ICU) at Jinyintan Hospital and one of the authors of the above papers, told the BBC on Monday (February 17) that the patient who developed the disease on December 1 was a man over seventies . The onset time on December 1 was a conclusion drawn from the epidemiological survey of the family members.
"This patient has a cerebral infarction and senile dementia, and the condition was very bad when he was sent over," Wu Wenjuan said. She declined to disclose the patient's last name.
It is reported that after the onset of the disease, the patient was first admitted to another hospital in Wuhan, but as the condition worsened, he was transferred to Jinyintan Hospital on December 29. At the time, Huang Chaolin and Wu Wenjuan were on the scene.
Wu Wenjuan said the old man had been sick at home before and had not visited the South China Seafood Market, a trading market in Wuhan that sells seafood and game products. Because a large number of merchants in this market became ill at the beginning of the outbreak, it was once considered the origin of the outbreak.
"He lives far from four or five stops (bus stops) at the seafood market," Wu Wenjuan said. "And because he was sick, he basically didn't go out."
According to a paper published in The Lancet, the elderly's family members did not develop fever or respiratory symptoms after the onset of illness, and there was no epidemiological link between them and subsequent patients. Ten days after his onset, three other people developed symptoms, two of whom had no history of exposure to the South China seafood market.
The BBC has not been able to independently verify this information.
Source of contradiction
The BBC asked Wu Wenjuan, "Why is this patient who has been living at home for a long time and has never been to the South China Seafood Market infected with this newly discovered virus? Is there any other possible source of infection?"
She avoided the problem.
"What you are asking is exactly the direction of our next research," said Wu Wenjuan.
But it is obvious that this contradicts the previous widely speculated that the epidemic was a large number of operators or game buyers of the South China seafood market that transmitted the virus directly to the South China seafood market.
Huang Chaolin previously said in an interview with the Chinese media "Caixin.com": "From the perspective of the current disease situation, the seafood market is not the only source of exposure ... it is multi-source," but he believes that the virus has It is likely to still come from wild animals.
This wild animal is now generally considered a bat. As early as February 3, Nature, an international authoritative academic journal, Nature published a research paper on the origin of the new crown virus by Shi Zhengli, a researcher at the Wuhan Institute of Virology, Chinese Academy of Sciences, who believed that bats were a possible source of the pneumonia epidemic.
At a press conference on Saturday (February 15), officials from the Chinese Ministry of Science and Technology reiterated that bats are still the most likely source of the new crown virus, but pangolin may be one of the intermediate hosts of the new crown virus.
This reminds people of the SARS epidemic that prevailed in China from 2002 to 2003. In this outbreak, scientists first thought that the virus originated from civet, but eventually the disease was identified as a bat. But to this day, the first SARS patient-a chef in Heyuan, Guangdong-still insists he has not been exposed to these wild animals.
Wuhan Virus Institute in Controversy
Are there other possibilities?
The Wuhan Virus Research Institute mentioned above is a focus that has recently been questioned by public opinion. As Chinese officials have been extremely secretive about the identity of the first patient, netizens have been questioning whether the first patient was an employee of the Wuhan Virus Research Institute.
For example, last Saturday (February 15), the rumor that "Wu Yanling, a female graduate student at Wuhan Institute of Virology, is a patient with New Coronary Pneumonia No. 0" was widely circulated in Chinese social media. "Patient Zero" generally refers to the first patient who became infected with the virus and started to spread the virus.
The institute and Huang Yanling's company had a "rumor rumor" on Sunday, saying that the lady "has been working and living in other provinces since graduation." Shi Zhengli, a researcher at the institute, told the media, "None of us have been infected with the virus, and we have zero infection."
In addition, as early as the outbreak of the outbreak, a paper from the Indian Institute of Technology team questioned that the four independent inserts of the new crown virus "is unlikely to happen by accident in nature," which instantly made the outside world for "Contributing to the creation of biological and chemical weapons" conspiracy theory has been raging, but then the author of the article announced the withdrawal.
According to Rutgers University biologist Richard H. Ebright, according to the BBC, according to the current genome sequencing of the virus, there is no evidence that the virus has been artificially modified. In Nature, he expressed concern about a bat virus experiment at the Wuhan Institute of Virology.
But Eblatt added that this does not represent a possibility that the virus from the outbreak could enter the population due to a laboratory accident.
He said that genome sequencing showed that the outbreak virus was very close to the bat coronavirus RaTG13 collected in a cave in Yunnan in 2003 by the Wuhan Virus Research Institute, with a genome-wide homology of 96.2%.
"This means that the virus is currently known to exist in two places: a cave in Yunnan and a laboratory at the Wuhan Institute of Virology," Eblet said. "It has been stored at the Wuhan Institute of Virology since 2013. "
On February 14, Chinese President Xi Jinping proposed at a meeting that biosafety should be “incorporated into the national security system” and the introduction of a biosafety law be promoted as soon as possible. The next day, the Ministry of Science and Technology of China demanded “strengthening the management of laboratories, especially viruses”.
When asked if the first elderly person diagnosed had any relatives related to the Wuhan Virus Research Institute or the South China Seafood Market, Director Wu Wenjuan of Jinyintan Hospital said that "it is impossible to draw conclusions" now.
https://www.bbc.com/zhongwen/simp/chinese-news-51540821
