WUHAN,CHINA - April 4, 2019 - Market stand selling vegetables inside street food market.

Bioethics Forum Essay

WHO-China Report on Covid: Important Step Forward, More to Be Done

The World Health Organization recently released a long-anticipated report on SARS-CoV-2 origins, based on 28 days of field research and site visits in China conducted jointly by 17 international and WHO experts and 17 Chinese counterparts. The report assessed possible pathways for the transmission of the coronavirus to humans and concluded that introduction through “an intermediate host” animal was likely to very likely, while a “laboratory incident”—the coronavirus escaping from a laboratory–was the least possible origin. Transmission from frozen food products was considered possible.

The report drew global attention and triggered a prompt response from United States, Canada, Japan, and several other countries, which issued a collective statement expressing their concerns and doubts. We believe the report is an important step forward, but that more needs to be done.

First, the WHO-China study process established an unprecedented global disease tracing and origins investigation. A joint team conducted the study with numerous health officials and other scientists across China providing support and expertise. The joint investigation provided a model for global health governance and global health security in the future.

Second, the joint investigation was an important signal of China’s commitment to collaboration, particularly considering the tension between U.S. and China and the sense of suspicion and distrust thus aroused internationally.

Third, the report provided valuable findings and reasonable recommendations, which pave the way for the further investigations. For example, the report found that the outbreak may have started in late September, but most probably between mid-November to early December. The team suggested next-phase studies to help trace the origins of the virus and proposed to convene a global expert group to support future joint research on the origins of epidemics.

Tracing the origins of a pandemic virus is always a challenge. It took decades to find that the 1918 influenza pandemic was similar to H1N1. And the exact origins of the outbreak are still in question. There is also a global consensus that the origins of SARS-CoV-2 must be found. The hundreds of millions of people who have suffered from the pandemic deserve accurate answers. The global community should work together to find them. To facilitate further investigation, we propose four basic principles as the compass of this joint effort.

Neutrality. Wuhan is the most probable place where the outbreak first occurred, even though evidence shows that there might have been cases of infection in other countries that preceded Wuhan’s December outbreak. But the joint report did not rule out the possibility that the outbreak could have originated from frozen food. So, it is important to conduct further investigations. The investigations should be neutral and scientific, without  political motivation or intervention. The goal is not punishment or stigmatization, but rather scientific knowledge, public good, global health security, and social justice.

Open, Fair, and Due Process. The investigation should be open and transparent. There should be a publicly agreed-upon and available ethical code of conduct for all participants. The basic rules should include forbidding trading favors, ex parte communications, and conflicts of interest.

Action Against Discrimination. Hate crimes against Asians have been increasing in the U.S. and other countries. They are fueled by the politicization of SARS-CoV-2 , which makes combatting the global pandemic a “blame game.” For example, Donald J. Trump, former president of the U.S., repeatedly called SARS-CoV-2 the “China virus,” blaming China for the pandemic. Governments around the world, together with  international organizations and citizens, should not only condemn the hate crimes, but also take actions to prevent them. A thoroughly global investigation and research on responsibility for the pandemic are desperately needed.

Cooperation. Global collaboration and cooperation are needed to continue investigating the origins of SARS-CoV-2 and combating the pandemic. But more is needed. We propose the creation of a global expert group to support future research on the origins of epidemics and pandemics. We also recommend, as part of global health governance, the organization and institutionalization of an independent investigation body to conduct comprehensive disease tracing.

Although the Covid-19 pandemic revealed weakness and shortcomings of China’s public health system, the low efficiency of bureaucracy in effective disease response, and incredible lack of public health knowledge even among health sectors, China showed great political willingness and strong leadership in combating the pandemic in a very efficient way. Meanwhile, ordinary citizens and health workers tried their best to stop the disease, often at costs of their own lives. China also helped other countries by providing protective products such as masks and made a commitment to provide vaccines as a global public good. The joint study on origins of SARS-CoV-2 is an important demonstration of China’s openness and sincerity in collaboration with global community on combating the pandemic. We believe future global collaborations by multiple stakeholders to investigate and combat Covid-19 and emerging pandemics–including meaningful engagement from China–are key to our common improved welfare.

Ruipeng Lei is a professor in the School of Philosophy and Executive Director of Huazhong University of Sciences and Technology, vice-president of Chinese Society for Bioethics, and a Hastings Center fellow. Renzong Qiu is a professor at Institute of Philosophy in the Chinese Academy of Social Sciences and a Hastings Center fellow. Ping Jia is executive director and founder of Health Governance Initiative, a senior research fellow at the Center for Bioethics of Huazhong University of Sciences and Technology, and vice-president of the Chinese Society for Bioethics.

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