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Home Politics & Law

Gain of Function in Wuhan

Daily Remedy by Daily Remedy
August 8, 2021
in Politics & Law
0

William of Ockham is known for his thoughts on philosophy and logic, none more famous than Ockham’s Razor, the principle that things are usually connected in the simplest or most economical way. That when attempting to explain the relationship between two or more things, we should give precedence to the simplest explanation.

When the World Health Organization (WHO) released its report on the origins of COVID-19, or more specifically, the SARS-CoV-2, the virus that causes COVID-19, the world was left with more questions than answers.

A sentiment echoed by WHO director-general Dr. Tedros Adhanom Ghebreyesus who said that, “all hypotheses remain on the table” regarding the origin of SARS-CoV-2, during the unveiling of a WHO report on the origin of the pandemic.

The report itself is largely informative, and delves into great detail about the epidemiology and biochemistry of the virus, most of which is substantiated by clinical studies or robust modeling backed by peer-reviewed data.

The curious part of the report comes at the end, when it lists the possible origins of the virus, in the last section prior to the Concluding Remarks called, Possible Pathways of Emergence. Ostensibly, when reading the report, it would appear that the claims of the virus’s origins are derived from the meticulous research done in previous sections leading up to claims about the origins of the virus.

But the report fails to explain the basis for these claims, instead listing different degrees of likelihood for the origins, without discussing how the likelihoods were derived, nor correlating the likelihoods with specific data or facts presented in the previous sections.

In its place, the report lists four scenarios in which investigators list possible origins of the virus and provide an “assessment of likelihood” for those possible origins based upon an inherently subjective evaluation of select data and broad findings that were presented earlier in the report.

Possible to likely: Direct zoonotic spillover

Likely to very likely: Introduction through an intermediate host followed by zoonotic transmission

Possible: Introduction through cold/ food chain [goods]

Extremely unlikely: Introduction through a laboratory incident

These assessments were then followed abruptly by a three sentence conclusion which simply called for additional investigations with the final line stating:

“In conclusion, the team called for a continued scientific and collaborative approach to be taken towards tracing the origins of COVID-19.”

Perhaps that was the intention of the report, to collect data and to presume possible causes without drawing any definitive conclusions. But the perception of the report was far different – and far more political.

Secretary of State Antony Blinken said on CNN that the Biden administration has, “real concerns about the methodology and the process that went into that report.”

In Australia the media was more direct. Sharri Markson, the television host of Sky News, a prominent media outlet in the country, called the report, “a piece of propaganda”, for the Chinese Communist Party.

Across the world, the general perception of the report came off as largely exculpatory towards the Chinese, which the world has already convicted in the court of public opinion for triggering the events that led to the pandemic. Perhaps these sentiments are well placed, as the Chinese have behaved oddly since the pandemic began.

But to conflate the ambiguity of the report as somehow being exculpatory towards the Chinese misses the mark entirely.

The Chinese undoubtedly have experimented with all sorts of viruses, including different versions of the virus that caused the pandemic. And the Wuhan Institute of Virology, the laboratory in question, has a well established record of publishing research in the field of virology known as ‘gain-of-function’, which is defined as, per a joint statement from the National Research Council & Institute of Medicine in 2015:

“Research that aim to produce a gain of a desired function, such as higher yields for vaccine strains, but often also lead to loss of function, such as loss of the ability for a virus to replicate well, as a consequence.”

In other words, any selection process involving an alteration of genotypes and their resulting phenotypes is considered a type of gain-of-function (GoF) research, which also includes increasing the infectivity and pathogenicity of the virus.

Research that the National Institutes of Health (NIH) is well aware of and actively funds, both domestically and internationally, while also acknowledging the potential risk inherent in these studies. The NIH has released its own statement warning about the risks inherent in GoF studies:

“Certain gain-of-function studies with the potential to enhance the pathogenicity or transmissibility of potential pandemic pathogens (PPPs) have raised biosafety and biosecurity concerns, including the potential dual use risks associated with the misuse of the information or products resulting from such research.”

So it should come as no surprise that this type of research is vehemently contested among leaders within the field of Virology, with some advocating for it while others in fierce opposition. And the tension within the scientists is mirrored by the conflicting policies over GoF research, usually drawn along political lines.

In 2014, under the Obama administration, the US government declared a moratorium on such research – putting GoF experiments on hold so the world could discuss the risks. But in 2017, the Trump administration green-lighted GoF research, ending the moratorium. And updates from the NIH in 2019 suggests that these studies were quite active just months before the pandemic even began – in the United States, in China, and across the world.

It is well within the realm of possibility that the SARS-CoV-2 virus was altered in a GoF experiment in China, and inadvertently infected a lab worker – which then found the perfect nidus for spread in a meat market known for the rapid spread of zoonotic viral infections due to the close proximity of exotic animals and highly dense human populations.

Such leaks have happened before, with alarming regularity, throughout the world.

In 1978, a laboratory photographer contracted small pox in Birmingham, England where researchers were actively trying to eradicate the viral disease. Somehow, the virus escaped the lab, though it was quickly contained. In 2014, as the Food and Drug Administration (FDA) found six vials of smallpox abandoned in an old facility in Washington DC. No one even knew the vials were there.

These are not isolated incidences confined to smallpox .The Centers for Disease Control & Prevention (CDC) has reported over 1,000 incidences of stolen or lost toxins between 2005 and 2012 – which can include anything from anthrax to a number of viral species. And these were only the reported incidences.

But to be clear, most viral outbreaks in recent years have emerged from naturally occurring viruses.

In 2003, the SARS outbreak spread to more than two dozen countries in North America, South America, Europe, and Asia before the global outbreak was contained. The virus that caused that outbreak is SARS-CoV-1, a corona virus that is closely related to SARS-CoV-2, and was first found in southern China in late 2002.

All of this is to say, as with everything related to this pandemic, there is more we do not know that what we do know. And what may appear very likely now, may prove less likely the more learn about SARS-CoV-2.

Yet there will inevitably be things we will never know with absolute certainty, and the best we can do is construct the simplest, most probable explanation – the pandemic’s Ockham’s Razor. Unfortunately, the origin of the pandemic is one of these things.

The genesis of every modern viral pandemic begins with a genetic mutation – some change in the viral genomic sequence brought about by a change that either allowed the virus to jump from an animal to a human or increase the spread of the virus from human to human.

But mutations are probabilistic. They occur spontaneously at varying rates across the genomic sequence of a virus. Some parts mutate more often than others. Some mutations are corrected, some lead to no meaningful change. Some increase function, some decrease function.

The problem is that we are attempting to decipher the probability of a specific type of mutation when all we have to go off of is circumstantial evidence and outright conjectures. There is no established framework through which we can calculate the cumulative probability of specific genomic mutations, and changes in a virus’s behavior, and changes in the virus’s infectivity across different populations.

And at this time we cannot say for sure whether the mutation in SARS-CoV-2 that led to the pandemic occurred naturally or was induced artificially through experiments at the Wuhan Institute of Virology.

So we are left to posture around circumstantial evidence that can easily support or refute any argument for the possible origin.

The WHO report believes the lab leak hypothesis is unlikely because the labs in Wuhan, “all had high quality biosafety level (BSL3 or 4) facilities that were well-managed,” and staff monitoring showed “no reporting of COVID-19 compatible respiratory illnesses prior to December 2019.”

But that conclusion contradicts a 2018 report from U.S. intelligence obtained by the Washington Post, which found that U.S. diplomats who visited the Wuhan Institute of Virology that year warned of, “serious safety issues.”

And in today’s internet cyber-society, when we are left with vague, circumstantial evidence, we tend to identify with the most extreme, conspiratorial explanation. So it should come as no surprise that immediately after the WHO report came out, additional evidence insinuating a massive cover-up also emerged. We began posturing about international cover-ups and global espionage.

We learned that one of the American scientists and many of the Western European scientists contributing to the report used $598,000 in grants from the NIH to fund research into the corona virus, at the Wuhan Institute of Virology between 2014 and 2020, some of which included GoF studies.

None of which was helped by the WHO, which somehow – even after a year of navigating through the chaos of the pandemic – has not understood how to deliver consistent, confident messaging. As though almost on cue, after the release of the report, Dr. Tedros added credence to the theory that the Chinese were withholding evidence:

“The team reports that the first detected case had symptom onset on the 8th of December 2019. But to understand the earliest cases, scientists would benefit from full access to data including biological samples from at least September 2019.”

Others at the WHO subsequently back-pedaled, claiming the report was merely a preliminary report, part of a broader, ongoing investigation.

But the damage was already done, and the political rhetoric spun into overdrive, which would now make it nearly impossible for an objective study to take place in the future. Too many news reports have already implicated a Chinese cover-up, some coming from widely read news outlets around the world.

This means that even if the pandemic began as a genuine accident, China will be implicated as though it was criminally liable.

But as Alison Young recently reported at USA Today, “these and similar safety lapses are happening with disturbing regularity at elite U.S. labs operated by government agencies, the military, universities and private firms. There is no reason to believe they aren’t happening at labs in other countries as well.”

A notion corroborated by former CDC director, Dr. Robert Redfield while being interviewed on CNN:

“If I was to guess, this virus started transmitting somewhere in September, October in Wuhan. It’s not unusual for respiratory pathogens that are being worked on in a laboratory to infect the laboratory worker.”

Yet, with the blame game in full spin, we are unlikely to obtain any further information beyond what we have, from any country or government agency, which means we have to make due with what we already have – in order to identify the most likely explanation – the pandemic’s Ockham’s Razor.

This means we are left to glean the most likely origin of the pandemic based upon the most probable type of viral mutation.

In a recent press conference, Dr. Anthony Fauci was asked to comment on Dr. Redfield’s belief that the virus originated in a lab. Dr. Fauci provided the following response:

“It [Dr. Redfield’s theory] is based on the idea that when the virus was first identified in late December of 2019, it seemed well adapted to transmission among the human population, suggesting it was adapted in the lab.”

Dr. Fauci went on to explain that most health professionals believe the virus had been circulating in China for weeks if not months, giving it plenty of time to adapt to rapid human to human transmission after adapting from animal to human.

Yet, Dr. Fauci’s explanation requires the virus to have mutated twice in a relatively short period of time, which from a probability standpoint is less likely than mutating only once.

But it is something we have seen SARS-CoV-2 do before, as there are numerous variants already circulating across the world, some still ravaging countries like Brazil. In India, some variants have already expressed a double mutation, which means the virus has benefited from two naturally occurring GoF changes.

In an interview with British Broadcasting Corporation (BBC) Virologist, Shahid Jameel, explained that a “double mutation in key areas of the virus’s spike protein may increase risks [of spread] and allow the virus to escape the immune system”, making it more infectious.

This means there is a precedent to multiple GoF mutations taking place over a rapid period of time.

But one mutation, no matter where in the genomic sequence it takes place, will always be more likely than two mutations, even in highly volatile areas of the genome. Which means the lab leak theory appears more likely, simply because it appears more probable – because one GoF mutation is more likely than two GoF mutations.

But until we fully sequence SARS-CoV-2 and study the patterns of mutation at different parts of the viral genome, we will never know for sure which mutations are most likely to occur. And even after we sequence the virus, we will only know the most probable origin – which may not be the actual origin, only the simplest explanation – the pandemic’s Ockham’s Razor.

Unfortunately, the simplest explanation has the greatest geopolitical implications.

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Daily Remedy

Dr. Jay K Joshi serves as the editor-in-chief of Daily Remedy. He is a serial entrepreneur and sought after thought-leader for matters related to healthcare innovation and medical jurisprudence. He has published articles on a variety of healthcare topics in both peer-reviewed journals and trade publications. His legal writings include amicus curiae briefs prepared for prominent federal healthcare cases.

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Summary

In this episode of the Daily Remedy Podcast, Dr. Joshi discusses the rapidly changing landscape of healthcare laws and trends, emphasizing the importance of understanding the distinction between statutory and case law. The conversation highlights the role of case law in shaping healthcare practices and encourages physicians to engage in legal advocacy by writing legal briefs to influence case law outcomes. The episode underscores the need for physicians to actively participate in the legal processes that govern their practice.

Takeaways

Healthcare trends are rapidly changing and confusing.
Understanding statutory and case law is crucial for physicians.
Case law can overturn existing statutory laws.
Physicians can influence healthcare law through legal briefs.
Writing legal briefs doesn't require extensive legal knowledge.
Narrative formats can be effective in legal briefs.
Physicians should express their perspectives in legal matters.
Engagement in legal advocacy is essential for physicians.
The interpretation of case law affects medical practice.
Physicians need to be part of the legal conversation.
Physicians: Write thy amicus briefs!
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