New Coronavirus News from 23 Mar 2023

China's only now revealed crucial COVID-19 origins data. Earlier disclosure may have saved us 3 years of political argy-bargy [The Conversation、 23 Mar 2023]

By Dominic Dwyer

Once more, we’re talking about the origins of SARS-CoV-2, the virus that causes COVID-19.
First the US Department of Energy’s review gave more emphasis to the laboratory leak hypothesis than previously, although the confidence for this conclusion was low.

Second, and more importantly, is the release and analysis this week of viral and animal genetic material collected from the Huanan wet market in Wuhan, the place forever associated with the beginning of the pandemic.

It’s a subject close to me. I was the Australian representative on the international World Health Organization (WHO) investigation into the origins of SARS-CoV-2. I went to Wuhan on a fact-finding mission in early 2021. I visited the now-closed market.

Now we have stronger evidence that places raccoon dogs at the market as a possible animal reservoir of SARS-CoV-2, potentially infecting humans.

If we’d had this evidence three years ago, we need to ask ourselves how different recent history would have been. We would have reduced the enormous energy, media frenzy and political argy-bargy about less likely hypotheses of the pandemic’s origins. We might have better focused our research attention.

Read more: COVID origins debate: what to make of new findings linking the virus to raccoon dogs

The twists, turns and puzzles
Samples were taken from various places in the market, in January 2020, within weeks of the early COVID-19 cases in Wuhan. SARS-CoV-2 RNA and human DNA were identified in these environmental samples, although no animal swabs were positive for the virus.

This was presented to the WHO team investigating the origins of the pandemic in January 2021, of which I was part.

The work was published as a preprint (posted online, before being independently verified) in February 2022.

The underlying “metagenomic” data to support the conclusions in the preprint – that SARS-CoV-2 and human (but not animal) sequences were present – needed to be provided to allow further analyses. This is something that is generally required by journals and regarded as appropriate in the spirit of scientific openness and collaboration.

However, it wasn’t until early March 2023 that the international community had access to the data.

That’s when there was a “drop” of these environmental metagenomic sequences into the GISAID database, the international open access repository of viral sequences.

This allowed an independent team of international experts to analyse them. In a startling revelation, they identified large amounts of raccoon dog and other animal DNA in conjunction with SARS-CoV-2. Raccoon dogs can be readily infected with SARS-CoV-2 and can transmit it. The international team published their observations as a preprint earlier this week.

Of note was the physical co-location of these virus and animal sequences in the corner of what is a very large market, the corner associated with early human cases. It is now known (but initially rejected by Chinese authorities) that wild and farmed animals were sold in this area of the market.

After the sequences were analysed by the international team, the Chinese scientists who had performed the market testing were contacted for comment and discussion – especially around the important observation that mixed in among the SARS-CoV-2 sequences were a large proportion of raccoon dog and other animal DNA.

The sequences were then withdrawn from the GISAID database within a few hours of the study authors being approached. This is perhaps unusual for an open database such as GISAID, and clarity could be sought why this occurred.

Why is this work important?
This latest work does not prove raccoon dogs were definitely the source of SARS-CoV-2. Presumably, they are likely to have been an intermediate host between bats and humans. Bats harbour many coronaviruses, including ones related to SARS-CoV-2.

However, the data fits the narrative of the animal/human connections of SARS-CoV-2.

This, along with other examination of animal links to SARS-CoV-2, should be taken in the context of the lack of robust data to support the other SARS-CoV-2 origins hypotheses, such as a laboratory leak, contaminated frozen food, and acquisition outside China. Bit by bit, the evidence supports animal origins of the outbreak, centred on the Huanan market in Wuhan.

The length of time taken for this early work to surface and the difficulty in accessing the raw data are unfortunate, points made recently by the WHO.

Sympathetically, one might say, the wrong analysis of the original data collected in early 2020 was undertaken and the researchers missed the animal links.

Cynically, (and without evidence) one might say that the significance of the data was recognised, but not made readily available. This is a question for the Chinese researchers at the Chinese Center for Disease Control to answer.

What are the implications of this delay?
If this had been identified in early 2020 then further studies to understand the viral origins in animals could have been undertaken.

Three years on, it is very difficult to do such studies, tracking backwards from the now closed market to the animal sources and the people who handled these animals.

Clearer answers would have taken some of the heat out of the debate around the possible viral origins. Of course, all hypotheses should remain on the table, but some of these could have been much better explored with earlier data.

Would it have changed the course of the pandemic? Probably not. The virus had already spread worldwide and adapted very well to human-to-human transmission by the time this work was available. However, it would have driven research in better directions and improved future pandemic planning.

What now?
Lessons for the future are obvious. Open disclosure of sequence data is the best way to undertake scientific investigation, especially for something of such international significance.

Making data unavailable, or not reaching out for assistance in complicated analyses, only slows the process.

The resulting political to and fro by all countries, particularly the US and China, has meant that suspicion has deepened, and progress slowed even further.

Although WHO has been criticised for errors in how it managed the pandemic, and in collating data to understand the origins and progress future research, it remains the best international agency to foster open sharing of data.

Scientists, for the most part, want to do the right thing and find the answers to important questions. Facilitating this is crucial.

China’s huge quarantine camps standing months after ‘zero COVID’ [Al Jazeera English, 23 Mar 2023]

Satellite imagery shows facilities are still intact nearly four months after the end of Beijing’s draconian pandemic policy.
Taipei, Taiwan – Nearly four months after China abruptly scrapped its tough “zero-COVID” policies following rare mass protests, authorities have yet to dismantle sprawling quarantine facilities designed for isolating hundreds of thousands of people, an Al Jazeera investigation based on satellite imagery shows.

Mass quarantine facilities in three Chinese provinces appear fully intact with no visible changes to their structure, an analysis of the satellite images shows, raising questions about the Chinese government’s post-pandemic plans for the now-defunct structures.

China’s quarantine facilities, which were previously used to isolate, and at times treat, positive COVID-19 cases and close contacts, became a symbol of the human cost of Beijing’s “zero-COVID” policy, which was dropped in December amid mounting public frustration with the draconian measures.

Beiijng’s overarching plan for its now-defunct quarantine centres, if there is one, is not clear.
Provincial authorities in Guangdong, Shandong and Sichuan did not reply to Al Jazeera’s requests for comment. Efforts to reach the National Health Commission (NHC) were unsuccessful.

In December, however, the NHC called on local governments to “upgrade” quarantine centres into hospitals with facilities including intensive care. The NHC said local authorities should carry out the upgrades with local needs in mind but did not specify the ratio or number of facilities that should be refurbished.

Meanwhile, some local governments have announced plans for a variety of other uses for the centres – from temporary housing to elderly care.

The satellite images obtained and analysed by Al Jazeera’s Sanad investigation unit cover six quarantine centres: three in northern China’s Shandong province, two in Guangdong province on the southern coast, and one in Sichuan in the centre of the country.

The facilities include Guangzhou’s 80,000-person capacity Nansha Health Centre, which was only completed in November. The furthest distance between locations – from the outskirts of Jining in Shandong to Guangzhou in Guangdong – is more than 1,700km (1,056 miles).

Sanad geolocated the quarantine centres using drone footage circulated on social media and analysed satellite images of the facilities taken within the last few days.

The images of quarantine centres analysed by Al Jazeera do not show any structural changes or construction to suggest significant upgrades.

For China, upgrading defunct quarantine centres en masse could potentially be a potentially difficult and costly task.

“Quarantine hospitals are designed in a very different way from acute care hospitals because for quarantine, the main purpose of the facility is to quarantine, not treatment,” Chi Chunhuei, director of the centre for global health at Oregon State University, told Al Jazeera.

While the Chinese government has not published official figures, news reports and official statements suggest that a large number of makeshift structures were erected across the country during the pandemic.

As early as January and February 2020, the National Development and Reform Commission allocated 530 million yuan ($77m) to quickly build two prefabricated COVID-19 hospitals in Wuhan, the then epicentre of the pandemic. China State Construction allocated another 500 million yuan (72.6m) to the project, which was modelled after a makeshift hospital built during the SARS pandemic in 2003.

The two facilities were dismantled in April 2020 as China began to contain the first COVID wave but the model would be widely adapted again two years later in the midst of an even larger infection wave in the spring of 2022.

As authorities struggled to contain the virus once again, local and city governments got to work to flatten the curve and ultimately achieve zero cases.

Chinese health official Jiao Yahui said there were 33 prefabricated hospitals completed or under construction in March 2022 alone. In May, the director of the NHC, Ma Xiaowei, called for more quarantine facilities in an op-ed for the Communist Party’s Qiushi Magazine.

China’s “zero-Covid” is gone, but quarantine facilities remain

Shanghai, a large COVID hotspot in 2022, by itself allocated at least 16.77 billion yuan ($2.4bn) for COVID-19 infrastructure, services, staff salaries and other needs in its 2022 budget. Like those of other local governments, the budget did not break down how much was spent on quarantine facilities specifically.

“The funding for the COVID infrastructure is a little bit opaque but it seems to come from a variety of sources, including SPB [special purpose bonds], central government budget and municipal/provincial budgets,” Arendse Huld, an editor at the business-intelligence website and magazine China Briefing, told Al Jazeera.

In August 2022, an NHC directive called for more reserve quarantine facilities, while stipulating they should be built with normal day-to-day functions in mind. Construction continued across China, including in Guangzhou, where authorities announced plans to build 36 facilities with a total capacity of 110,000 beds as late as November 2022.

Discussions on the costs and future of the quarantine facilities are difficult to find in China’s heavily-censored media.

A critical article on the news platform 163.com, which questioned who would pay for Shandong to dismantle quarantine camps built at a cost of 23 billion yuan ($3.3bn), had its contents deleted, although its title remains visible online.Much of the cost of China’s quarantine centres was funded by debt.

Chinese financial news site Yicai reported that more than 100 local governments issued special purpose bonds, racking up debts of up to 440 million yuan ($63.9m).

Many of the local authorities said they planned to rent out the facilities after the pandemic to generate income and fund the debt.

Huld, the editor, said authorities may find it difficult to make the centres economically viable if converted to other uses, which could include hotels, office buildings, shopfronts, warehouses, expo centres and even parking lots.

“I think it’s reasonable to be sceptical of the viability of these facilities for long-term use and of whether they can really generate income in the future,” Huld said.

“These facilities were not made to be permanent and so it seems unlikely that they will really have much longevity. This sentiment is also being felt in China, as we can see from various social media posts [and] web articles.”

In Jinan, the capital of Shandong province, a 650-cabin quarantine camp – that spans more than 20,000 square metres (215,000 sq feet) – was converted into temporary housing for “skilled talent” to resolve a housing shortage for people working at a nearby tech complex, an official statement said. In Shandong, at least one quarantine facility has been designated to become an elderly care home.

Government authorities in remote Qinghai on the Tibetan Plateau said 29 quarantine camps with more than 10,000 beds in total would be kept open to provide reserve beds.

The NHC also recommended that some quarantine centres could be upgraded to medical facilities but Jin Dong-yan, a professor of medicine at the University of Hong Kong, questioned their suitability.

He said the facilities are typically in less-than-ideal locations, far from urban centres, while the buildings themselves would not meet medical standards.

“Even if you build a new hospital from the ground up, there may not be manpower to run it,” Jin told Al Jazeera.

China’s rural areas have just 2.4 practising physicians and 2.6 registered nurses per 1,000 people, according to data compiled by China Briefing, far fewer than urban areas, where the ratio is 3.7 practising physicians and 4.6 nurses.

Jin said authorities might try to save face by repurposing the centres regardless of their long-term viability or suitability.

“The money has already been spent, the best they can do is try to recycle the waste,” he said.
Despite the unresolved questions, Beijing has cast its handling of the pandemic as an unqualified success.

During China’s National People’s Congress earlier this month, newly-appointed Premier Li Qiang said China’s COVID-19 policies were “completely right” and “delivered highly effective outcomes”.

After praising China’s “remarkable” transition from “zero-COVID”, Li said China would continue to “strengthen medical and health services at all levels” and improve its early warning system for epidemics.

China’s official death toll is just 120,576, according to World Health Organization statistics. Health experts widely agree that figure greatly underestimates the actual toll, with some academic studies estimating 1-1.5 million deaths.

While some quarantine facilities may find other uses, others are likely to be consigned to the ash heap of history, said Chi, from Oregan State University, particularly if they are built on highly-sought urban land.

“If they are built in a more suburban area, the land value is not so high, they will probably not tear them down and they can convert them into other use,” he said. “But if some of the quarantine hospitals were built on high-value city land, there’s a high likelihood they will tear it down or modify them into commercial buildings because they desperately need to boost [economic] growth.”

For some Chinese, the centres stand as reminders of the draconian policies that upended the economy and their personal lives for the quixotic goal of zero infections.

For Guangzhou local Jenny, who asked not to be identified by her name, even the sight of kiosks built for PCR testing still haunts her.

“They remind me of painful memories, what else can there be?” Jenny told Al Jazeera.

Jenny, who vividly recalls images of police deploying batons, water cannons and tear gas against protesters during last year’s anti-lockdown protests, is not worried about what happens to the quarantine centres.

Like many Chinese, she just wants to move on from the pandemic.

“The average person does not care,” Jenny said.