Can be that the genetic weakness of the genetic pool of the Asians
Early Coronavirus Genetic Data May Have Forewarned Outbreak
By Jason Gale
February 12, 2020, 5:57 AM GMT+3 Updated on February 12, 2020, 10:21 AM GMT+3
Preliminary genetic data indicated SARS-like virus on Dec. 26
Virus reporting systems need to utilize modern sequencing data
China didn’t release key genetic data on the coronavirus until about two weeks after it emerged that a new SARS-like illness may be sickening people, highlighting the need for outbreak detection systems to incorporate modern scientific tools.
Insufficient attention was paid to the information doctors had gathered about the genetic sequence of the novel coronavirus, scientists said in a commentary paper in the Lancet medical journal Tuesday. The authors, who include two members of the World Health Organization’s emergency committee, said this wasn’t the result of a cover-up or deliberate delay, but rather the absence of mechanisms to inform outbreak warning systems.
ELMAT: The system did not have a protocol to be followed.
The data were generated by a genomic analysis technique known as next-generation sequencing that represents an advance in the detection of new pathogens. Once the sequence of the so-called 2019-nCoV virus was shared publicly via the World Health Organization, scientists around the globe used it to diagnose cases. The pneumonia-causing virus, which emerged in the central Chinese city of Wuhan in late 2019, has infected about 45,000 people, killing over 1,110, mostly in China.
“To be fair to the authorities, I think all national responses would do what the Chinese did,” said Lin Fa Wang, one of the four authors of the Lancet paper. “This is not a cover up or delay, this is all about policy and ‘rules of engagement’ for reporting. I hope people focus on the lessons learned.”
Reporting MechanismIn China and other countries, there are no systems in place to adequately report next-generation sequence data -- information that can sometimes be misleading, Wang said in an email Wednesday. Establishing a reporting system that utilizes modern analytical tools could help national and global authorities respond faster to outbreaks.
The preliminary sequencing data indicating the presence of a severe acute respiratory syndrome, or SARS-related coronavirus, in specimens collected from patients’ lungs in China were obtained on Dec. 26, according to the Lancet paper.
Authorities in China ruled out SARS and a related coronavirus known as MERS, as well as a few other non-coronaviruses, on Jan. 5, and confirmed a new coronavirus was the potential cause of the pneumonia outbreak on Jan. 9, the authors said.
“However, the genome sequence -- crucial for rapid development of diagnostics needed in an outbreak response -- was not released until Jan. 12, 17 days after the preliminary sequence data were obtained,” the authors said.
The scientists questioned whether the response to emerging viruses emanating from animals could be accelerated by placing greater value on the information collected by doctors, as well as gene sequence data on new pathogens. Authorities in China waited until the existence of the new coronavirus had been confirmed by traditional methods, which involve isolating the viral culprit. This may have led to a delayed response to the outbreak.
Doctor-Detectives
“It was the clinicians who led to the early detection of, and warning about, the 2019-nCoV outbreak in China,” the authors said.
In investigating the severe pneumonia cases caused by the unknown pathogen, clinicians in two Wuhan hospitals independently sent patient specimens for gene sequencing analysis by commercial companies, according to the paper.
“Alarm bells rang, not only through the different levels of the official Chinese Center for Disease Control and Prevention reporting system but also through social media traced back to eight doctors who were wrongly accused of spreading ‘fake news’,” the authors said. “These doctors were later cleared of any wrongdoing and praised by the government authorities for their brave action in early alerting.”
Anger in China was directed toward a few leading scientists who were alleged to have held back sharing data about the virus to publish their findings, according to the Lancet paper.
“These unsubstantiated allegations consumed media attention and created media panic that was counterproductive to the outbreak response,” the authors said, adding that clear national and international guidelines are needed on how to achieve the right balance in leadership provided by public health and research experts facing an outbreak of an emerging virus.
Fast WorkThe speed with which authorities in China announced a mysterious outbreak of pneumonia in Wuhan linked to the city’s major seafood market “was fast by most international standards,” said John S. Mackenzie, a co-author, in an email. “I doubt many other public health authorities would have been any faster.”
It’s unlikely any public health authority would announce the cause of a newly described outbreak based on a couple of genetic sequences, Mackenzie said. By early January, several sequences corroborated the 2019-nCoV finding, he said.
The six-member Chinese team investigating the outbreak initially included only one person trained in animal health. More veterinary specialists might have improved the team’s ability to identify an intermediate animal source of the 2019-nCoV virus, the authors said.
They proposed that the novel coronavirus be named “Han acute respiratory syndrome coronavirus,” or HARS-CoV -- noting that “Han” is the abbreviation of Wuhan in Chinese, and encouraged health authorities to “reflect on the lessons” from the outbreak and other zoonoses, or diseases transmissible from animals to humans.
“There are lessons the global health community can and should learn and act on so that we can better respond to the next emerging zoonotic virus event, which is almost certain to happen again,” the authors said. “These lessons are definitely not unique to China.”
(Adds detail about investigation team and suggested name in final three paragraphs.) |
