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18 Mar 2020: David Christopher Lung, Yuen Kwok-yung: Pandemic Originated from Wuhan; Lesson from 17 Years Ago Forsaken
Winter of Jihai (2019), a virus began in Wuhan. Comes spring of Gengzi (2020), an epidemic broke out in Hubei. Within China, there were 80,000 confirmed cases, and 3,000 deaths. People were confined in their homes and the epidemic only began slowing down towards the end of the month, yet the virus had leaked to the world outside before it could be stopped. In March, it was a pandemic, only it was announced too late by the World Health Organization (WHO). Countries lacked measures and reserves, and the pandemic swept across the globe. Singapore, Hong Kong, Macau, and Taiwan were spared from the pandemic with continuous sprinkles of overseas imported cases and small groups, but have not yet fallen.
This pandemic came from a virus, shaped like a corona, hence named Coronavirus. Since 2015, WHO has avoided using names of people, places, animals, food, culture, occupation, etc., to name illnesses. For this one, the “year” was used for differentiation, COVID-19. In the naming of viruses, International Committee on Taxonomy of Viruses (ICTV) analyses only the genome sequencing meticulously and disregards the other aspects. Since the genome sequence of this Coronavirus was “not novel enough”, it belongs in the same sisterhood with the SARS Coronavirus, also known as SARS 2.0 (SARS-CoV-2). Local and international media call it the Wuhan Coronavirus or Wuhan Pneumonia, simple and straight-forward, which is not incorrect.
Much controversy has resulted in society regarding the name of this pandemic. In fact, the illness was named by WHO, while the virus was named by ICTV. Nicknames are conventional, as long as they are clear and understood. In scientific discussions or academic exchanges, COVID-19 or SARS-CoV-2 must be used. In daily public communications or media wordings, Wuhan Coronavirus or Wuhan Pneumonia are both conventional, easy to understand, and great for communication purposes.
The Pandemic of Gengzi, an Origin in Wuhan
Around 75% of the newly discovered infectious diseases originated from wild animals. Among the few that could infect mammals is the Coronavirus, whose ancestral virus originated from bats or avians. Both have the ability to fly thousands of miles to the place the virus was first discovered, therefore the naming of a virus would also include its place of origin. To investigate the origin of a virus, the correct and objective way is to isolate the virus from the animal host. Unfortunately, since Huanan Seafood Wholesale Market was eradicated early on, the wild animals in the market were already gone by the time researchers had arrived to collect samples. The identities of the natural host and the intermediate host became a mystery. According to the locals, the wild animals sold within the Market came from all over China, Southeast Asia, and Africa (smuggled) to be distributed from there. The ancestral virus of the Wuhan Coronavirus cannot be determined.
Using genome sequencing to determine its origin, a bat Coronavirus stand (RaTG13) was found to be extremely similar to the Wuhan Coronavirus, with a sequencing similarity of 96%, therefore it is believed to be the ancestral virus stand of this Wuhan Coronavirus. This particular virus strand was obtained and isolated from Yunnan bats (Rhinolophus sinicus), and bats are believed to be the natural host of this Wuhan Coronavirus. Epidemiology clearly indicated Huanan Seafood Wholesale Market as the amplification epicenter, where there was a huge possibility that the virus had cross-infected between the natural host and the intermediate host, and then mutated within the intermediate host to adapt to the human body, followed by human-to-human infections.
The identity of the intermediate host remains unknown, but genome sequencing indicated that the Spike Receptor-binding domain of the Wuhan Coronavirus has a 90% similarity to that of the pangolin Coronavirus strand. Although the pangolin could not be confirmed as the intermediate host, it is highly possible that this pangolin Coronavirus strand donated Spike Receptor-binding domain DNA (or even the entire sequence) to the bat Coronavirus strand. Though gene shuffling recombination, the novel Coronavirus was born.
Wild Animal Market, the Origin of Innumerable Viruses
The 2003 SARS virus originated from Heyuan, became an epidemic in Guangdong, and passed to Hong Kong. The SARS Coronavirus was found in civets, and China clearly banned the trading of wild animals afterward. 17 years on, the wild animal market has run amuck. The Chinese have outright forgotten the lessons from SARS and have allowed a live wild animal market to exist within the centre of a highly developed city, with wild animals being cooked and eaten in brought daylight – simply astonishing. The feces of the animals within a live wild animal market contain a large amount of germs and viruses. With a crowded environment, vile hygiene, and a mix of wild animal species, gene shuffling and mutation could easily occur in viruses, therefore these markets must be banned.
Reform of the wet markets should be a focus of epidemic prevention. The mainland Chinese and Hong Kong governments must quickly improve these environments by enhancing ventilation and pest control. Before the complete elimination of live-animal markets, animal feces must be well handled to minimise the chances of gene shuffling in viruses.
The online rumour that the virus originated from USA was absolutely groundless, delusional. Stop spreading the falsity before we expose ourselves to ridicule. To remain calm before a pandemic, informational transparency is of the utmost importance. With calm and objective analysis, refrain from parroting others and spreading hearsay. Not strictly enforcing the closure of all wild animal markets after SARS was a grave mistake. In order to defeat an illness, one must own up to the mistakes and face the truths. Stop committing the same mistakes and putting the blame onto others. The Wuhan Coronavirus was a product of the inferior culture of the Chinese people: excessive hunting and ingesting wild animals, inhumane treatment of animals, disrespecting lives. Continuing to devour wild animals for human desires, the deep-rooted bad habits of the Chinese people are the real origin of the virus. With this attitude, in a dozen years, SARS 3.0 is bound to happen.
(Dr Lung graduated in 2004 from the University of Hong Kong, Faculty of Medicine with distinction in Medicine. He currently works in the Hong Kong Children’s Hospital, where he built up the microbiology team and lab. Yuen Kwok-yung is a Professor and Chair of Infectious Diseases of the Department of Microbiology of the University of Hong Kong)
(Original image by Ming Pao)
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