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Thursday, May 23, 2024

We Need a Global Outbreak Investigation Team—Now

This week, a much anticipated fact-finding mission into the origins of Covid-19 returned from a month-long field visit to China. The team of scientists appointed by the World Health Organization are currently writing up their findings, which will be published in a summary report next week, with a full report expected to follow sometime after that. But on Tuesday, at a joint briefing with Chinese health officials, the team’s leaders gave the world a sneak peak at what new information they had unearthed. In short, not much.

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“Did we change dramatically the picture we had beforehand? I don’t think so,” said Peter Ben Embarek, a zoonosis expert with the WHO who headed the investigation. Like a majority of scientists, the group still favors the idea that SARS-CoV-2 originated in animals before spilling into humans. “Did we improve our understanding? Did we add details to that story? Absolutely,” he continued.

The most significant detail the group added was its apparent dismissal of the controversial laboratory release hypothesis, which Ben Embarek called “extremely unlikely.” The declaration was a boost to Beijing’s version of events, which has peddled unsubstantiated claims that SARS-CoV-2 could have originated outside of China, and kicked off a new round of geopolitical bickering over who should shoulder the blame for Covid-19 becoming a global pandemic. However, on Friday, WHO director-general Tedros Adhanom Ghebreyesus seemed to backtrack, saying at a press briefing that “all hypotheses remain open and may require further analysis and studies.” He also acknowledged that the WHO probe might not be best positioned to come up with those answers. “Some of that work may lie outside the remit and scope of this mission,” he said.

Which leads one to wonder, if not the WHO, then who? It’s something many biosecurity experts have been thinking about for years. The WHO, by its very charter, is inherently limited in how intrusive it can be. The organization can only enter member countries and engage in research there on those countries’ terms, and it has no real powers of enforcement. And if anything, the last twelve months have highlighted just how constraining those limitations can be and have illustrated the need to try something new.

“We need to go about things differently to rapidly assess the origins of an event with such global consequences,” Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, told WIRED via email. “We should have international agreement that any novel unexplained epidemic event with high international impact will be rapidly and impartially investigated using all the tools of the latest global science.”

Though he didn’t offer specific alternatives, other models for ensuring greater oversight on a global scale already exist. There’s the International Atomic Energy Agency, or IAEA, which monitors nuclear activities across the 191 signatories to the Treaty on the Non-Proliferation of Nuclear Weapons. Its inspectors conduct regular—sometimes surprise—visits to facilities to verify that nuclear materials are only being used for peaceful purposes and not being weaponized.

There’s also the OPCW, the Organization for the Prohibition of Chemical Weapons, which is the enforcement agency for the 1997 Chemical Weapons Convention. It has the authority to investigate attacks and inspect chemical plants in any of the nations that have ratified the convention’s terms. “You could envision a similar international body that could require BSL-4 labs to report on the activities that go on inside them,” says Gregory Koblentz, director of the biodefense graduate program at George Mason University. BSL-4 stands for biosafety level 4, a title bestowed on the kinds of facilities that are equipped to study the world’s most dangerous and exotic pathogens. There’s already an existing legal structure under the Biological Weapons Convention—the international treaty banning such weapons’ development—that could, in theory, create the enforcement authority for an agency.

But given that the Biological Weapons Convention operates by the consensus of its 183 state parties, and they haven’t been able to agree on any major initiatives since 2005, that approach might be too slow to make a difference. It’d also be overkill. Since fewer than 40 countries actually have BSL-4 labs, you’d just need as many of those nations as possible to sign on to a separate agreement subjecting them to international oversight by a new agency dedicated to bio-risk management. Other countries could join as needed.

Alternatively, says Koblentz, the UN Security Council could establish such a body, the same way it created commissions to inspect Iraq for possible weapons of mass destruction. Doing that without having them tainted by the legacies of those entities—whose investigations were used to justify the US invasion of Iraq, despite not turning up any weapons—well, it could be tricky.

Both of those would take time. International treaties don’t happen overnight. As a stopgap measure, Filippa Lentzos, a biosecurity expert at Kings College London, has proposed the World Health Assembly—the decisionmaking body that governs the WHO—as another possible avenue for mandating investigations that can get boots on the ground the moment reports of an outbreak with pandemic potential emerge. But that approach, too, would likely rely on the voluntary cooperation of member states. 

The WHO task force, by the way, feels that their results are being undersold. During a press briefing Friday, WIRED asked WHO officials and mission team members how well they thought they’d done. Ben Embarak acknowledged that his team was still far from pinpointing the exact origins of SARS-CoV-2, but he listed a series of smaller successes, including new insights into the virus’s early days in Wuhan. Genetic sequencing showed the first cases actually began earlier than initially reported—as early as December 8, 2019. And some of those infections were in people with no relationship to the Huanan Seafood Market, the site of the city’s first large outbreak. “So we have a much better understanding of the role of the market than we did before,” he said.

WHO mission team member Marion Koopmans, a virologist specializing in molecular epidemiology at the Erasmus University Medical Centre in the Netherlands, made the point that sometimes the success is in what you don’t see—the leads they chased down that turned out to be nothing. For example, they saw data from experiments in which Chinese scientists screened 30,000 animals from all over the country for susceptibility to SARS-CoV-2. They all tested negative. “In this case, that tells us there’s not a clear candidate for intermediate hosts yet,” Koopmans said.

Their overall message is that the full report is still to come, and while it may not have all the answers, it is a first step toward getting them. “We’ve made progress,” said Mike Ryan, head of the WHO’s Health Emergencies Programme. “That’s all you ever make in science.”

If the world’s nations are going to set up a stand-alone agency for monitoring high-risk life science research, one that can be deployed at the earliest sign of an emerging outbreak—be it natural, accidental, or intentional—it’s still unclear which mechanism will be the right one. It’s more obvious that the need for increased oversight is only going to grow more acute in the near future. If past pandemics are any indication, Koblentz says he expects many countries to put a lot of money into boosting their biomedical research capabilities in the coming years. The construction of the Wuhan Institute of Virology was itself a response to the 2003 SARS outbreak and China’s limited ability at the time to isolate and characterize the coronavirus that caused it. And though it was the first BSL-4-level facility in China, it won’t be the last. The government has announced plans to build between five and seven more across the Chinese mainland by 2025.

More money and momentum for studying the diverse coronavirus family tree should be an unmitigated good. Figuring out how the viruses behave and how likely it is that any one can make the hop to humans will be key to predicting where the next pandemic might come from. Having a well-distributed global network of sophisticated labs to conduct surveillance, identify emerging pathogens, and develop diagnostics to detect them will be key to preventing the next Covid from becoming, well, the next Covid.

You don’t need a BSL-4 lab to study coronaviruses. But you do need them to conduct so-called “gain-of-function” or “dual-use” research—experiments involving genetically tweaking pathogens to make them more dangerous than nature evolved them to be. This kind of research could, in theory, illuminate the conditions under which viruses might evolve to be more human-friendly, allowing scientists to forecast where and how future spillovers are most likely to occur. Partly for that reason, they have an outsized appeal as a status symbol. Expensive to build and even more expensive to maintain, they’re a sign of a nation having “made it” to the highest tiers of technological sophistication. But they also require significant training and resources to run safely.

Which is why the prospect of a proliferation of labs should be reason enough for rethinking the status quo, says Koblentz. “An international mechanism would be an extremely smart investment to make now, before you have this coming boom in BSL-4 labs that is going to make the oversight question even harder,” he says. Not only would such an agency help to ensure that the next wave of coronavirus research meets adequate safety standards, but having regular inspections by a neutral party could go a long way toward creating confidence in the investigation the next time there’s a major outbreak of a contagious disease. “It’s the lack of transparency, it’s the lack of cooperation that has allowed these kinds of allegations and concerns to fester,” says Koblentz. “And that makes it that much harder to determine what caused the emergence of this pandemic in the first place.”

Those failures may have left the public to marinate in misinformation for the last 12 months, but they’ve also awakened the world to the latent dangers posed by the proliferation of BSL-4 labs. And not seizing the moment would be a missed opportunity, says Lentzos. “The origins question feeds into a bigger societal debate that we still need to have about the risks we’re willing to take in the name of research,” she told WIRED via email.

A high-risk biology research oversight agency might be a smart investment, but it will require the kind of government cooperation that seems in shorter and shorter supply these days. “Developed nations, which control the majority of high-containment biological labs, have made it clear that the global order tends toward individual nations supervising their own labs the way they want without interference from others,” says Nick Evans, a bioethics expert at the University of Massachusetts Lowell.

Add to that the way that, in response to Covid-19, many such nations have doubled down on trying to engineer their way out of a public health crisis—with rapid development of vaccines and treatments, rather than public education about how to stop the virus from spreading—and he doesn’t see much chance of countries, especially the wealthiest ones, changing any time soon. “I don’t imagine them having the political appetite to restrict scientific research in any way, given that they think scientific research is the way we’re going to get out of this pandemic and future pandemics,” he says.

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