Book Excerpt: Sounding the First Alarm on Covid-19

by Gregory Zuckerman

Wuhan is a beautiful place. It’s also full of danger.

The capital of central China’s Hubei province, Wuhan is an enormous city of 11 million, about as many as the combined populations of New York City and Chicago. Full of spectacular lakes and lush parks, Wuhan is divided by the magnificent Yangtze River and historically important Han River. The city boasts high-speed trains to various cities around China and flights to the rest of the world, with three train stations and a major international airport ferrying a steady stream of visitors.

Wuhan has long been known for a variety of fish dishes, thanks to its proximity to fresh water, and a hot noodle dish known as reganmian. Like some other big Chinese cities, Wuhan — at least prior to the pandemic — was also home to dozens of sprawling markets that sold a variety of fresh meat, fruits, seafood, and vegetables. Some were known to slaughter live animals on-site for their customers. Animals for sale included raccoon dogs, civets, mink, badgers, rabbits, hedgehogs, and baby crocodiles. Much of the wildlife trade is illegal, and though most of the species sold in Wuhan’s markets are protected by the government, there was precious little enforcement. In response to Covid-19, Chinese leaders ultimately banned the sale of wildlife for food, though markets continue to sell fish, poultry, and other meats.

Many of the wild animals that were butchered in the Wuhan markets are susceptible to infection and can transmit viruses. And they were often stored in cramped, unhygienic conditions, making it easy for pathogens to jump species. The storage and handling of the animals has long been a matter of concern, partly because similar conditions led to serious problems elsewhere in the country. In 2002, the SARS-CoV coronavirus first appeared in and around a similar market in the southern Chinese city of Foshan, about 621 miles from Wuhan. More than a third of the early patients who developed the SARS disease were food handlers who likely had close contact with some of these same animals.

In December 2019, word began to emerge about a mysterious sickness spreading in the Wuhan area. Reports on social media and elsewhere described dozens of people sick from some kind of respiratory virus. No one knew the cause of the ailments — in early January, The Wall Street Journal described it as “a mystery viral pneumonia” that was causing “fever and breathing difficulties.” Some of the infections were linked to vendors at the Huanan Seafood Wholesale Market, one of the city’s bigger markets, featuring a complex set of stalls and alleyways. It wasn’t clear if the sickness originated in the market or if it was merely spreading there, but Chinese authorities, who already were battling an outbreak of African swine fever in the country, ordered it shut down.

Around midday on Friday, Jan. 3, Zhang Yongzhen, a 58-year-old infectious disease expert at the Shanghai Public Health Clinical Center, which is part of Fudan University, received a package he had been eagerly awaiting: a metal box containing a test tube, packed in dry ice, with lung-washing swabs from a patient suffering from the new virus in a Wuhan hospital. They had all been in the Wuhan market or lived nearby. Zhang and his colleagues got right to work and didn’t stop for the next 40 hours, spending two straight nights in the lab. By 2 a.m. on Sunday, Jan. 5, the team had mapped the virus’s genome, or its complete set of genetic instructions, declaring the pathogen to be “very similar to SARS-type coronavirus.” They also noticed a gene producing a spike protein on the pathogen’s surface, one that resembled the one used by SARS-CoV to bind to human cells.

This was truly bad news — SARS had inflicted enormous damage on China, sparking the kind of social unrest that kept authorities up at night. If the new pathogen was anything like that one, the country was in some trouble. Local scientists knew it and so did Chinese officials. Over the next week, though, Chinese authorities went out of their way to reassure the public and others. Wuhan health officials said they hadn’t seen new cases in the previous week, which was encouraging, and they hadn’t found “significant” human-to-human transmission, though they didn’t elaborate on what “significant” meant.

The World Health Organization, a United Nations agency specializing in global health, issued statements complimenting China’s public health resources as well as its system for monitoring illness outbreaks, providing more reason for comfort. Wuhan itself was the home of China’s first Biosafety Level 4 laboratory, a specialized research laboratory dealing with potentially deadly infectious agents, a sign the city was no scientific backwater. Experts said that even if a new coronavirus had in fact emerged, it was unlikely to have the impact of the virus that led to SARS. Health authorities had learned so much since 2002 and the Chinese government was better prepared to respond, they said.

For all the calm and confidence displayed by health authorities and others, Zhang and other Chinese scientists were becoming alarmed about what was happening in Wuhan. They were especially worried about a family of six who lived in a different and even larger city, Shenzhen, nearly 700 miles away. Just before the New Year, the family had traveled to Wuhan for a weeklong visit. Now, five members of the family were infected with Wuhan’s new virus, each suffering from a variety of maladies, including fever, upper or lower respiratory tract symptoms, and diarrhea.

People get sick while traveling; it happens. But what was especially troubling about this case was that one of the family members hadn’t made the trip to Wuhan, yet had still become infected with the new virus after several days of contact with family members. It was a clear sign the virus was potentially transmittable between people. Just as chilling: One family member — a 10-year-old who was later described in the medical journal The Lancet as being “non-compliant to parental guidance,” seemingly because he didn’t wear a surgical mask during the Wuhan vacation like another child on the trip — had become infected yet didn’t demonstrate any symptoms of the virus. That was great for him, but awful for everyone else. To Zhang and others, it meant many more asymptomatic people in the country and elsewhere could already be carrying and spreading the new virus, without anyone knowing they had been infected.

Zhang, who also worked for the Chinese Center for Disease Control and Prevention, had to figure out what to do. A few days earlier, the National Health Commission (NHC), an agency that oversees the Chinese CDC, had ordered labs with samples of the new virus to destroy them or hand them to the government. The agency forbid researchers from publishing any details about the virus.

Zhang looked at his phone and saw another email from Eddie Holmes. He had been emailing for days but Zhang mostly ignored him. Holmes, an infectious disease specialist at the University of Sydney, had written a number of scientific papers with Zhang about the evolution of various new and emerging viruses. They were even working on a paper about respiratory disease in Wuhan, of all places. Now, Holmes was hearing chatter about an emerging virus in the city and he was desperate to learn what Zhang knew about the new pathogen.

“Are you working on it?” Holmes asked in yet another email.

Zhang didn’t share any details about his work or the new virus. It didn’t seem necessary, and he feared such a disclosure would cause trouble. Early on Sunday, Jan. 5, though, a few hours after he finished sequencing of the virus genome, Zhang sent an email to Holmes, who read it as his wife drove their car to a Sydney beach for an outing with family members visiting from the United Kingdom.

“Please call me immediately!!!” Zhang wrote.

Holmes excused himself from his guests and phoned Zhang. They began discussing details of the new pathogen and its similarities with previous deadly viruses. Almost simultaneously, they reached the same conclusion.

“It’s SARS, it’s SARS!” Zhang said.

Shit, it’s back, Holmes thought, referring to another pernicious coronavirus.

Zhang and his colleagues in China began cautioning authorities in the country. After sending a warning to the NHC, Zhang boarded a flight to Wuhan, where he told senior public health officials in the city that they needed to take emergency measures to protect against spread of the pathogen ahead of the busy Lunar New Year holiday season later that month.

That wasn’t enough, Holmes told Zhang. Cases were growing in Wuhan, Hong Kong, and elsewhere. You need to share the genetic details of the virus with the world, Holmes said. If a SARS-like pathogen is spreading, testing kits would be needed within days. A vaccine might even be required. But no test kits or vaccines could be produced without knowledge of the virus’s genetic makeup.

Zhang was torn. He was a serious scientist who had sequenced thousands of virus genomes in his career. Like Holmes, Zhang was sure the genetic data he had would make a well-read paper in a high-profile journal, a goal of every researcher. The two researchers had received interest in their paper from the prestigious journal Nature. The information would be helpful to scientists around the world. Yet Zhang also knew Chinese authorities wanted to control information about the new virus. Other government labs had decoded the same genetic material, and a few days later Chinese leaders confirmed they were dealing with a new coronavirus. But they still sat on the genetic information. It was a warning sign to Zhang — the Chinese government didn’t want the information released, possibly because it would invite scrutiny of the country’s handling of the new virus.

Zhang had already dealt with his share of recent personal trauma. Several months earlier, Zhang’s wife had died of cancer, and he was still mourning her loss. He led a stressful life, even apart from that tragedy. Zhang was so busy chasing viruses that he sometimes slept two or three nights a week in his office. The last thing he wanted was to add more tension to his life. He already had done a lot to help stop the virus. It seemed wise to avoid crossing his superiors and to do nothing more with the genetic information.

Now Holmes was getting frustrated. Each day without the genetic information meant another day before tests could be developed, potentially jeopardizing global health. Besides, he and Zhang had a huge scoop they were bound to lose to some other researcher. Word was getting out that the sequence data was available, and that a scientific paper had been written, but someone was refusing to release it. On Jan. 10, Jeremy Farrar, the director of the huge Wellcome Trust in the U.K., one of the largest foundations in the world, tweeted that if the rumors are true and someone wasn’t releasing this crucial information, “something is very wrong.”

Oh God, that’s me! Holmes thought.

Holmes called Farrar, asking if he might be able to get the Chinese CDC to share the sequence and try to persuade Zhang. Then Holmes called Zhang, trying to convince him once again.

“We really, really need it,” he told Zhang, but he resisted the entreaty.

On the morning of Saturday, Jan. 11, Zhang sat on a plane on the runway at Shanghai Hongqiao International Airport. He was about to take off for Beijing so he could warn additional authorities about the virus, when he got another call from Holmes.

“Can you release it?” Holmes asked.

“I need to call you back,” Zhang said.

The cabin crew saw Zhang speaking on his mobile phone and ordered him to turn it off.

“You need to release it to me,” Holmes said.

Silence.

“Okay,” Zhang said softly.

Zhang made a quick call to a staffer in his lab. A few minutes later, Holmes saw an email with an attachment in his inbox. He did a quick calculation and realized it was after midnight in Edinburgh, Scotland, the home of Andrew Rambaut, an academic who ran a website called virological.org. He and Holmes had agreed to publish the sequence on his open site if Zhang ever released the information. Rambaut, a night owl, picked up the phone right away. Holmes told him the sequence was on its way. Holmes hadn’t even read Zhang’s attachment — there wasn’t any time.

“It could have been DNA from a blowfly,” Holmes says. “I didn’t even check.”

Fifty-two minutes later, during the evening of Friday, Jan. 10, on the East Coast of the United States, the information was available and scientists around the world were furiously downloading the sequence of the virus, which later would be named SARS-CoV-2. A day later, the Chinese CDC officially released the virus’s genetic information and Holmes felt enormous relief. Finally, the world could start defending itself against the new virus.

“It was a weight off my shoulders,” Holmes says.

Zhang was just as thrilled, at least at first. A day later, though, he began to come under pressure from Chinese authorities. They were unhappy that the nation was receiving criticism for its handling of the emerging virus, and that he had released the sequence without their permission. Holmes sent emails to senior officials saying Zhang’s act had benefited global science and health. It was a great moment for China. Don’t punish Zhang, he urged the officials.

Soon, though, Zhang’s lab was temporarily closed for “rectification,” and funding for his research was suspended.

Gregory Zuckerman is a Special Writer at The Wall Street Journal, a 20-year veteran of the paper, and a three-time winner of the Gerald Loeb award — the highest honor in business journalism. He is the author of several books, including "The Man Who Solved the Market" and "The Frackers: The Outrageous Inside Story of the New Billionaire Wildcatters." He lives with his wife and two sons in West Orange, N.J.

This article was originally published on Undark. Read the original article.