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【《财新》独家披露：冠状病毒· 早期发现· 官方抑制·传播全球】
｛深入探讨：如何发现，传播和抑制类似于SARS的病毒的早期迹象｝
In Depth: How Early Signs of a SARS-Like Virus Were Spotted, Spread, and Throttled
参与报道记者：高瑜，彭艳峰，杨锐，冯玉鼎，马丹梦，弗林·墨菲，韩伟和沈慧敏
出版时间：2020年2月28日；《财新》
《财新》调查显示，这种新的冠状病毒已经在中国实验室进行了测序，这种病毒已经夺走了将近3000条生命，并传播到了近50个国家，并被发现与SARS类似。 找到了。
12月，来自多个实验室的测试结果表明爆发了新病毒。 然而，尽管被送入旨在向中国高级卫生官员警告疫情爆发的传染病控制系统中，结果仍未能引起公众的反应。
这些揭示表明，卫生官员如何在爆发的最初阶段错过了控制病毒的早期机会，因为关于谁知道什么时间，何时知道这些行动是否有助于疾病传播的问题越来越多。
早在12月27日，一家位于广州的基因组学公司就从一名65岁送货员的肺部液体样本中测序出了大部分病毒，该送货员在海鲜市场工作，其中出现了许多头例病例。 结果显示与致命SARS冠状病毒的惊人相似之处，后者在2002年至2003年之间导致近800人死亡。
大约在那个时候，当地医生从武汉附近的医院向至少包括中国重量级BGI在内的多家中国基因组学公司发送了至少八份其他患者样本，他们致力于确定越来越多的原因不明的呼吸道疾病背后的原因。 结果全部表明是一种危险的SARS样病毒。
就在几天前，中国于12月31日通知世界卫生组织（WHO）出现了一种未知的传染病，距它与世界共享该病毒的基因组序列还有两周，而至关重要的是，距中国当局确认已超过三周 公开指出该病毒正在人与人之间传播。
有关这种新疾病的担忧最初是由一小部分医务人员，研究人员和官员负责的。 12月30日，李文亮博士是武汉市最早响起警报并在网上发布初步证据的人之一。 因发布信息而受到惩罚的李在感染患者后五周后将死于该病。
1月1日，几批基因组序列结果返回医院并提交给卫生部门后，一家基因组公司的员工接到了湖北省卫生委员会官员的电话，命令该公司停止测试样品。 来自武汉的与新病有关的疾病，并销毁了所有现有样本。 该员工不愿透露姓名，并说要立即停止发布测试结果和有关测试的信息，并向当局报告任何将来的结果。
然后在1月3日，中国国家最高卫生主管部门国家卫生委员会（NHC）下令，机构不得发布与未知疾病有关的任何信息，并下令实验室将其必须携带的任何样品转移至指定的检测机构，或销毁这些样品。 他们。 财新看到的命令没有指定任何指定的测试机构。
世卫组织流行病学家布鲁斯·艾尔沃德（Bruce Aylward）在周二在北京举行的新闻发布会上解释了疫情的发生过程和应对措施。
照片：CGTN
1月9日，中国当局最终宣布，武汉市爆发了病毒性肺炎，这是一种新型冠状病毒。 即使到那时，该病毒的传播能力也被低估了，使公众仍未意识到迫在眉睫的危险。
最终，在1月20日，呼吸卫生方面的领导机构钟南山在抗击非典的过程中引起了全国关注，他在电视采访中证实该疾病正在人与人之间传播。
两天后，拥有一千一百万人口的武汉被封锁。 今天它仍然被隔离。
社交媒体帖子提供了线索
最早的结果是在武汉海鲜市场工作的一名65岁送货员，该结果于12月27日由视觉医疗公司（Vision Medicals）返回，该公司位于中国广东省广州市黄埔区，是一家基因组公司。
该患者于12月18日因肺炎入武汉市中心医院，病情迅速恶化。 医院呼吸内科负责人赵苏说，12月24日，医生从他的肺部抽取了液体样本，并送往Vision Medicals进行测试。
该公司没有回传结果，而是在12月27日给医生打电话。“他们只是打电话给我们，说这是一种新的冠状病毒，”赵说。
Vision Medicals证实测试是在上周晚些时候在社交媒体上发布的帖子中进行的。 该帖子称，该公司参与了对新冠状病毒的早期研究，并为在《中国医学杂志》英文版上发表的有关其发现的文章做出了贡献。 该文章特别提到了12月24日从一名与海鲜市场接触过的65岁患者那里收集的样本。
据信由Vision Medicals员工撰写的另一篇社交媒体文章进一步阐明了该公司的早期工作。 该帖子的作者于1月28日发表，只说他们在Vision Medicals所在地广州黄埔的一家私人公司工作。
该帖子的作者说，他们在12月24日收集的样本的测试结果中注意到与SARS冠状病毒非常相似，但由于其重要性，他们决定在返回结果之前进行更仔细的研究。 文章称，该公司确实与中国医学科学院共享数据。
文章说，在12月27日，实验室工作已经对该病毒的大部分基因组进行了测序，并确认它是一种类似于SARS病毒的冠状病毒。
文章说，在接下来的几天里，公司高管访问了武汉，与当地医院官员和疾病控制部门讨论了他们的发现。 它说：“正在进行深入而机密的调查，医院和疾病控制中心的官员已经承认了许多类似的病人。”
有关此早期研究的很少信息已正式发布。 该患者转入武汉市金银塘医院，随后死亡。
中国科学院武汉病毒研究所。 图片：丁刚/蔡欣
由“小错误”触发的启示
在Vision Medicals的研究人员对他们的发现进行思考的同时，武汉市中心医院将另外两名神秘肺炎患者的拭子送往位于北京的实验室CapitalBio Medlab Co. Ltd.进行研究。
其中一个样本来自一名没有与海鲜市场接触史的41岁男子，他于12月27日入院。
该公司提供的测试结果显示
对SARS的误报。 基因测序专家告诉财新，这是一个“小错误”，可能归因于基因数据库有限或缺乏重新测试。
但是，正是这个错误引发了公众的首次关注-回忆起17年前定义SARS爆发的掩盖事件的痛苦回忆。
12月30日晚，武汉的几位医生，包括已故的李文亮在内，私下分享了CapitalBio的结果，以警告朋友和同事采取保护措施。 这些消息随后在网上广泛传播，并引发了公众的骚动，要求提供更多信息。 包括当天晚上发送邮件的李和其他两名医生在内的几人后来因“散布谣言”而受到当局的惩罚。
湖北新华医院呼吸科主任张继贤于12月26日注意到，他从附近的海鲜市场接获越来越多的肺炎症状患者。 他于第二天向医院报告了情况，并将报告转交给市和省级卫生部门。
根据这些报道，武汉和湖北的疾病控制部门于12月30日发出内部通知，警告出现肺炎患者，这些患者与海鲜市场有关，并要求医院进行监测。
该通知随后在网上泄漏，使公众对官员们对此次疫情的承认有了第一眼的印象。
静音警报
财新获悉，其他几家基因组公司也在12月下旬在武汉对当时不明病毒的患者样本进行了测试。
行业领导者BGI于12月26日从武汉一家医院收到了一个样本。测序已于12月29日完成，并显示虽然不是引起SARS的病毒或严重的急性呼吸道综合症，但它是以前看不见的冠状病毒 80％与导致SARS的病毒相似。
BGI的一位消息人士告诉《财新》，当他们在12月下旬进行测序项目时，该公司并未意识到该病毒已经使许多人患病。 消息人士说：“我们每天都要接受大量的测序委托。”
财新了解到，武汉医院于12月份向华大基因送出了至少30份来自不同肺炎病例的样本进行测序，发现其中3份含有新的冠状病毒。 除了12月26日的病例外，12月29日和12月30日还收到了第二个和第三个阳性样本。它们一起进行了测试，并将结果最早于1月1日报告给武汉市卫生委员会。
一位员工说，1月1日，基因测序公司接到了湖北省卫生委员会的命令，要求停止测试并销毁所有样品。该人士说：“如果您将来进行测试，请务必将其报告给我们。”
两天后的1月3日，国家卫生委员会发布了堵嘴令，并称武汉肺炎样本需要作为高致病性微生物处理-任何样本都必须移至认可的检测设施或销毁。
一位病毒学家告诉《财新》杂志，甚至连中国科学院武汉病毒研究所（WIV）也没有资格进行测试，并被告知要销毁实验室中的样品。
但是那天，上海复旦大学的张永珍教授从武汉市中心医院收到了用干冰装在金属盒中并通过铁路运输的生物样本。 到1月5日，张的小组还通过高通量测序鉴定了新型的SARS样冠状病毒。
张向上海市卫生委员会和中国国家卫生委员会报告了他的发现，警告新病毒类似于SARS，并通过呼吸道传播。 1月6日，这引发了中国疾病预防控制中心（CDC）的第二次应急响应。
据中国国家广播电视台CCTV报道，1月9日，由疾病预防控制中心领导的专家小组初步得出结论，该病是由一种新的冠状病毒引起的。
1月11日，张的团队率先在公共数据库Virological.org和GenBank上发布了该新病毒的基因组序列，并首次向世界展示了其结构。 NHC次日与世界卫生组织共享了病毒基因组信息。
同样在1月11日，武汉市卫生委员会在暂停报告数天之后，恢复了更新新病毒的感染病例。 但是政府再次宣称没有医务人员感染，也没有人传播的证据。
同时它报告说，确诊病例已降至41 例。
联系记者Flynn Murphy（flynnmurphy@caixin.com），Han Wei（weihan@caixin.com）和Timmy Shen（hongmingshen@caixin.com，Twitter：@timmyhmshen）和编辑Michael Bellart（michaelbellart@caixin.com）
Happy A Pleasant Weekend & Take Care Everyone ！
Translated by : XiaHeBingYu
Date: 02-28-2020
*** Attachment：Original Article ***
In Depth: How Early Signs of a SARS-Like Virus Were Spotted, Spread, and Throttled
By Gao Yu, Peng Yanfeng, Yang Rui, Feng Yuding, Ma Danmeng, Flynn Murphy, Han Wei and Timmy Shen
https://www.caixinglobal.com/society-and-culture/
The new coronavirus that has claimed nearly 3,000 lives and spread to almost 50 countries was sequenced in Chinese labs — and found to be similar to SARS — weeks before officials publicly identified it as the cause of a mysterious viral pneumonia cluster in Wuhan, a Caixin investigation has found.
Test results from multiple labs in December suggested there was an outbreak of a new virus. However, the results failed to trigger a response that could have prepared the public, despite being fed into an infectious disease control system that was designed to alert China’s top health officials about outbreaks.
The revelations show how health officials missed early opportunities to control the virus in the initial stages of the outbreak, as questions mount about who knew what and when, and whether these actions helped the disease to spread.
As early as Dec. 27, a Guangzhou-based genomics company had sequenced most of the virus from fluid samples from the lung of a 65-year old deliveryman who worked at the seafood market where many of the first cases emerged. The results showed an alarming similarity to the deadly SARS coronavirus that killed nearly 800 people between 2002 and 2003.
Around that time, local doctors sent at least eight other patient samples from hospitals around Wuhan to multiple Chinese genomics companies, including industry heavyweight BGI, as they worked to determine what was behind a growing number of cases of unexplained respiratory disease. The results all pointed to a dangerous SARS-like virus.
That was days before China notified the World Health Organization (WHO) on Dec. 31 about the emergence of an unidentified infectious disease, two weeks before it shared the virus’s genome sequence with the world, and crucially, more than three weeks before Chinese authorities confirmed publicly that the virus was spreading between people.
Concerns about the new disease were initially kept within a small group of medical workers, researchers and officials. On Dec. 30, Dr. Li Wenliang was one of several in Wuhan who sounded the first alarms and released initial evidence online. Li, who was punished for releasing the information, would perish from the disease five weeks later, after contracting it from a patient.
On Jan. 1, after several batches of genome sequence results had been returned to hospitals and submitted to health authorities, an employee of one genomics company received a phone call from an official at the Hubei Provincial Health Commission, ordering the company to stop testing samples from Wuhan related to the new disease and destroy all existing samples. The employee spoke on condition of anonymity, saying they were told to immediately cease releasing test results and information about the tests, and report any future results to authorities.
Then on Jan. 3, China’s National Health Commission (NHC), the nation’s top health authority, ordered institutions not to publish any information related to the unknown disease, and ordered labs to transfer any samples they had to designated testing institutions, or to destroy them. The order, which Caixin has seen, did not specify any designated testing institutions.
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WHO epidemiologist Bruce Aylward explains the process and response to the outbreak at a news conference in Beijing Tuesday. Photo: CGTN |
It was Jan. 9 when Chinese authorities finally announced that a novel coronavirus was behind Wuhan’s viral pneumonia outbreak. Even then, the transmissibility of the virus was downplayed, leaving the public unaware of the imminent danger.
Finally, on Jan. 20, Zhong Nanshan, a leading authority on respiratory health who came to national attention in his role fighting SARS, confirmed in a TV interview that the disease was spreading from person-to-person.
Two days later, Wuhan, a city of 11 million, was placed in lockdown. It remains quarantined today.
Social media posts provide clues
The earliest results, for a 65-year-old deliveryman who worked at the Wuhan seafood market, were returned on Dec. 27 by Vision Medicals, a genomics company based in Huangpu district in Guangzhou, South China’s Guangdong province.
The patient was admitted to the Central Hospital of Wuhan on Dec. 18 with pneumonia and his condition quickly deteriorated. On Dec. 24, the doctors took fluid samples from his lungs and sent them to Vision Medicals for testing, according to Zhao Su, head of respiratory medicine at the hospital.
In an unusual move, the company did not send back results, but instead called the doctor on Dec. 27. “They just called us and said it was a new coronavirus,” Zhao said.
Vision Medicals confirmed the tests took place in a post it published on social media late last week. The post said the company was involved in early studies on the new coronavirus and contributed to an article published on the English version of the Chinese Medical Journal about its discovery. That article makes specific mention of a sample collected on Dec. 24 from a 65-year-old patient who had contact with the seafood market.
A different social media post, believed to have been made by a Vision Medicals employee, sheds more light on the company’s early work. The author of the post, made on Jan. 28, said only that they worked at a private company based in Huangpu, Guangzhou, where Vision Medicals is located.
The post’s author said they noticed a close similarity with the SARS coronavirus in test results of a sample collected on Dec. 24, but decided to study the results more closely before returning them, due their significance. The company did, however, share the data with the Chinese Academy of Medical Sciences, according to the article.
On Dec. 27, the lab worked had sequenced most of the virus’s genome and had confirmed it was a coronavirus similar to SARS virus, the article said.
In the following days, company executives paid a visit to Wuhan to discuss their findings with local hospital officials and disease control authorities, the article said. “There was an intensive and confidential investigation underway, and officials from the hospital and disease control center had acknowledged many similar patients,” it said.
Little information about this early study has been officially released. The patient, who was transferred to Wuhan Jinyintang Hospital, later died.
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The Wuhan Institute of Virology, part of the Chinese Academy of Sciences. Photo: Ding Gang/Caixin |
Revelations triggered by ‘small mistake’
While researchers at Vision Medicals mulled their findings, the Central Hospital of Wuhan sent swabs from two other patients with the mysterious pneumonia to a Beijing-based lab, CapitalBio Medlab Co. Ltd., for study.
One of the samples came from a 41-year-old man who had no history of contact with the seafood market, who was admitted on Dec. 27.
Test results delivered by the company showed
a false positive for SARS. It was a “small mistake,” a gene sequencing expert told Caixin, which may have been down to a limited gene database or a lack of retesting.
But it was this mistake that triggered the first concerns heard by the public — recalling painful memories of the cover-up that defined the SARS outbreak 17 years before.
On the evening of Dec. 30, several doctors in Wuhan, including the late Li Wenliang, privately shared CapitalBio’s results as a warning to friends and colleagues to take protective measures. Those messages then circulated widely online and sparked a public uproar demanding more information. Several people, including Li and two other doctors who sent the messages that night, were later punished by authorities for “spreading rumors.”
Zhang Jixian, who heads the respiratory department at Hubei Xinhua Hospital, noticed on Dec. 26 that he had received a growing number of patients with symptoms of pneumonia from the neighboring seafood market. He reported the situation to the hospital the next day, with that report passed on to city and provincial health authorities.
Following the reports, disease control authorities in Wuhan and Hubei on Dec. 30 issued an internal notice warning of the emergence of pneumonia patients with links to the seafood market and requiring hospitals to monitor similar cases.
The notice, later leaked online, offered the first glimpse to the public of officials’ acknowledgement of the outbreak.
Silenced alarms
Several other genomics companies also tested samples from patients in Wuhan with the then-unidentified virus in late December, Caixin learned.
Industry leader BGI received a sample from a Wuhan hospital on Dec. 26. Sequencing was completed by Dec. 29, and showed while it was not the virus that causes SARS, or severe acute respiratory syndrome, it was a previously unseen coronavirus that was about 80% similar to the virus that causes SARS.
A BGI source told Caixin that when they undertook the sequencing project in late December the company was unaware that the virus had sickened many people. “We take a lot of sequencing commissions every day,” the source said.
Caixin has learned that the Wuhan hospital sent BGI at least 30 samples from different pneumonia cases for sequencing in December, and three were found to contain the new coronavirus. In addition to the Dec. 26 case, the second and third positive samples were received on Dec. 29 and Dec. 30. They were tested together and the results were reported to the Wuhan Municipal Health Commission as early as Jan. 1.
On Jan. 1, gene sequencing companies received an order from Hubei’s health commission to stop testing and destroy all samples, according to an employee at one. “If you test it in the future, be sure to report it to us,” the person said they were told by phone.
Two days later on Jan. 3, the National Health Commission issued its gag order and said the Wuhan pneumonia samples needed to be treated as highly pathogenic microorganisms — and that any samples needed to be moved to approved testing facilities or destroyed.
One virologist told Caixin that even the Wuhan Institute of Virology (WIV) under the Chinese Academy of Sciences was not qualified for the tests and told to destroy samples in its lab.
But that day, Professor Zhang Yongzhen of Fudan University in Shanghai received biological samples packed in dry ice in metal boxes and shipped by rail from Wuhan Central Hospital. By Jan. 5, Zhang’s team had also identified the new, SARS-like coronavirus through using high-throughput sequencing.
Zhang reported his findings to the Shanghai Municipal Health Commission as well as China’s National Health Commission, warning the new virus was like SARS, and was being transmitted through the respiratory route. This sparked a secondary emergency response within the Chinese Center for Disease Control and Prevention (CDC) on Jan. 6.
On Jan. 9, an expert team led by the CDC made a preliminary conclusion that the disease was caused by a new strain of coronavirus, according to Chinese state broadcaster CCTV.
On Jan. 11, Zhang’s team became the first to publish the genome sequence of the new virus on public databases Virological.org and GenBank, unveiling its structure to the world for the first time. The NHC shared the virus genomic information with the World Health Organization the next day.
Also on Jan. 11, the Wuhan Municipal Health Commission resumed updating infection cases of the new virus after suspending reports for several days. But the government repeated its claim that there had been no medical worker infections and that there was no evidence of human transmission.
Meanwhile it reported that the number of confirmed cases had dropped to 41.
Contact reporters Flynn Murphy (flynnmurphy@caixin.com), Han Wei (weihan@caixin.com) and Timmy Shen (hongmingshen@caixin.com, Twitter: @timmyhmshen), and editor Michael Bellart(michaelbellart@caixin.com)
（The End）
Have a Wonderful Sunday !
Reedited by: XiaHeBingYu
Posted Time: March 1 , 2020 ; 3:50AM PST
