ALL THE DUCKS IN CHINA
I first heard about a new virus transmitted from bat to human weeks before this became the only topic in the United States. Back then I did a Google search of “Wuhan and virus” and on the first page of Google I learned that there was a highly restricted laboratory called the Wuhan Institute of Virology.
Labs that study viruses are numbered depending upon how trivial or deadly the virus is. So level-1 handles germs that don’t make people sick, whereas level-4 handles the most contagious and deadly germs. For example, HIV and Hepatitis can be studied at level-2 whereas Ebola is studied at level-4.
A level-4 laboratory is extremely complicated structurally and socially. Every detail of the building is meticulously planned – from the dramatic triple set of doors and air locks and astronaut-like clothing, to the routine floors and cabinets. It also requires an unusual culture – able to be both highly disciplined and extremely open because every person, from the directors to the custodians, must feel free enough to disclose potential errors.
There are about 50 level-4 laboratories in the world. We have 13, Russia has one, South Korea has one, and Taiwan has two. Despite (or because of) the danger, it seems to be a point of professional and national pride for a country to have its own level-4 laboratory.
In 2018 China opened its first level-4 laboratory. In Wuhan.
From the very beginning, United States scientists said that there were safety breaches in China’s first level-4 lab. Specifically, they said that the lab “represented a risk of a new SARS-like pandemic.” This was not too surprising, because it had been well documented that the SARS virus had escaped many times from China’s level-3 lab in Beijing.
As a typical American, I do a lot of Google searches. As a physician, I don’t have a preconceived idea of what the truth should be. I always thought journalists shared these exact two traits.
But for at least a month I never heard a reporter even mention there was a lab in Wuhan. It was simply presented as fact that a bat from the wet market transmitted the virus. The first time I heard a reporter even mention there was a lab near the market was to mock it as a conspiracy theory. He did not even identify the lab as being a level-4 lab.
That reminded me of something that I learned in my training.
Every medical student goes through a phase when they are sure that they have diagnosed a rare disease. Television shows are filled with this drama: the brilliant doctor who discovers that his patient’s high blood pressure is caused by a rare tumor, and not the mundane reasons of being overweight, too much salt/tobacco/stress. But in real life, every med student has heard her professor say: “If it looks like a duck, walks like a duck, and quacks like a duck … it’s a duck.”
So if a journalist went to med school, it would have been drilled into him that if a new, highly contagious, highly lethal virus, is discovered in the same city where there is a sophisticated laboratory that studies new, highly contagious, highly lethal viruses; the cause of the virus is probably a duck – and not a bat.
I would have thought that older journalists would teach younger journalists similarly, that perhaps once in their career they may discover a bat, but most often, they would be reporting duck sightings.
I would have thought that journalists were taught to keep an open mind to the possibility of discovering a bat, but not to close their mind to the probability that they are seeing a duck.
My Google searching techniques are not superior to a journalist. The clues were so obvious that they could only have been missed if a journalist had consciously or subconsciously wanted to miss them. I had no preconception when I started my search, and this is what I learned in about five minutes.
• there was only one BSL-4 lab in all of China
• the BSL-4 lab was located in the same city where the virus originated
•.this BSL-4 lab became operational only two years ago
• China had repeatedly failed to contain the SARS virus in a lower level lab
This virus has thus far has caused hundreds of thousands of deaths, threatened multi-trillion dollar world economies, and disrupted billions of lives. This magnitude of destruction was possible only because the Wuhan Institute of Virology was located in a city with 11 million people and an international airport.
So I did an additional Google search this week and found that the Wuhan international airport has 24 million passengers a year. The silver lining of this pandemic is that China selected Wuhan and not Beijing to be the site of its deadliest lab. Thankfully Wuhan has only half the population and a quarter of the passengers of Beijing – home to the second busiest international airport in the world.
China has already announced plans to build at least five more BSL-4 labs.
Including one in Beijing.
Let’s hope, even now, we get all our ducks in a row.
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