The November story

China's account of what happened in Wuhan is incomplete. So too are the accounts of foreign scientists and the American government

*** Please be sure to read the updates at the end of the document as the science has moved on in some of this essay. Given the controversial nature of this topic, I’ll try and update important issues when I can ***

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This week I want to set sail into choppy and difficult waters. I want to try to assemble some of what we know about the origins of covid-19 into some sort of order. On this matter, there are many journalists who have written with perseverance and brilliance. So this isn’t an easy subject to write about, and there are no easy answers to be had. But, even so, there are pieces of the puzzle to be pondered to see if there is an outline of a bigger picture.

Because this is a longish newsletter here is an outline of what I want to talk about.

• Summary of the findings of the Biden Intelligence review

• The American consulate in Wuhan

• Open secrets -- who else knew in December?

• Was the virus spreading in Wuhan’s schools by November?

If you know someone who would like to read this newsletter, please do share it.

Summary of the findings of the Biden Intelligence review

Last month the Biden intelligence review into the origin of covid-19 arrived. For the great unwashed little more than a page was declassified. It was a bit of a damp squib. Its inconclusive findings were covered in many places (see here, here & here). In brief, contact with an infected animal (a zoonosis), or a laboratory-related incident, both remain plausible hypotheses.

Four parts of the intelligence community (IC) and the National Intelligence Council assess with low confidence that initial infection was most likely by natural exposure to an infected animal infected with SARS-COV-2 itself—or a virus that was 99% similar. However one element of the IC dissents. It assesses with moderate confidence that the first human infection was the result of a laboratory-associated incident. This would be either experimentation, animal handling, or sampling by the Wuhan Institute of Virology (WIV).

At this point, it is worth noting that the IC in America comprises 18 organisations of varying sizes. The Central Intelligence Agency and the National Security Agency are the most important. Reading this report, then, what we don’t know is how important this dissenting branch of the IC is. Is it a dinky, obscure bit of the IC, or is it a big powerful part? Without knowing this we can’t say if there is a standoff among equals or something else entirely.

It would be a mistake to assume the report said nothing. In fact, the IC agrees on a few issues.

1: the virus was not developed as a biological weapon

2: China’s officials did not have foreknowledge of the virus before the initial outbreak emerged (i.e. it was surprised)

3: that human infection probably started with an initial small-scale exposure

4: this happened “no later than November” (my highlight).

Personally, I think it is fair to assume that these points are relatively stable knowledge in a shifting sea of storylines about what happened in Wuhan prior to the official Chinese timeline.

The Chinese timeline begins, entirely implausibly, with a single case on December 8th¹. The phrase “no later than November” means the outbreak could have started far earlier. But either way, America is saying that covid-19 started earlier than the Chinese say it did.

How does the IC know this? The intelligence community has access to signals intercepts, satellite imagery, human intelligence, as well as published data. And, hopefully, scientists are more willing to talk to the intelligence services than they are to journalists. It increasingly seems that the novel outbreak was a matter of discussion by mid-December both inside and outside of China (see Open secrets -- who else knew in December?) Phylogenetic work has also calculated that a viral emergence as early as October 6th is compatible with the known genetic sequences. There is also quite a bit of evidence for Chinese cases in November.

The consulate

America has a consulate in Wuhan. Known as ConGen Wuhan, the Consul General is Jamie Fouss. ConGen Wuhan knew something was up by at least mid-December.

In telling this part of the story, keep in mind that December 30th is a key date for China on the timeline². On December 30th, the head of the Chinese CDC, George Gao Fu, notices in a WeChat group that Wuhan has issued an emergency notice to health care in the city. And in the evening of that day, at 7pm to be precise, the “mysterious patient samples” arrive at the Wuhan Institue of Virology. On December 31st the Chinese will notify the rest of the world about the outbreak.

So how do we know that ConGen Wuhan knew there was a disease outbreak earlier than this?

They wrote about it in an article in April 2020, in State Magazine, written by Russell Westergard, the Deputy Consular Chief in Wuhan. The context is a story about the consular evacuation from the city. Mr Westergard writes that by mid-October of 2019, Wuhan had been struck by “an unusually vicious flu season”. This unusual flu season worsened in November. By mid-December, Wuhan was closing public schools.

By mid-October 2019, the dedicated team at the U.S. Consulate General in Wuhan knew that the city had been struck by what was thought to be an unusually vicious flu season. The disease worsened in November. When city officials began to close public schools in mid-December to control the spread of the disease, the team passed the word to Embassy Beijing and continued monitoring. The possibility of a new viral outbreak was always on the consulate’s radar. Still, the working assumption in every scenario had always been that, as in past outbreaks like H1N1 (known as swine flu), it would appear in rural areas first and then spread to major urban centers across China.

One might read this and conclude that mid-December was the moment ConGen Wuhan started to pay attention. But the account doesn’t preclude any earlier discussions. Westergard is clear in his account of that time that “the possibility of a new viral outbreak was always on the consulate’s radar”. Jamie Fouss is an old Asia hand, and with bird flu and SARS coming from China, any serious disease outbreak would have been of interest. Did the vicious flu season really merit no remarks throughout October and November?

There is a specific medical branch of the Defense Intelligence Agency in America that is tasked with gathering just such information. One news story suggests that it knew something was up in November. This branch is called the National Centre for Medical Intelligence (NCMI), and it is based in Fort Detrick, Maryland. Its purpose is to collect, evaluate and analyse worldwide health threats and issues. Two newspaper reports suggest the NCMI started its outbreak investigation as early as November 2019.

Newspaper stories about the intelligence agencies can often be quite vague. That isn’t the case with the story, from ABC News on April 9th, 2020. It is very specific. (Kudos to Josh Margolin and James Gordon Meek.) The story says the NCMI knew about a contagion sweeping through Wuhan in late November. The outbreak was changing the patterns of life and business, and posing a threat to the population. A report was compiled. This detailed a novel outbreak that was based on an analysis of “wire and computer intercepts coupled with satellite images”. The analysts concluded the outbreak could be a “cataclysmic event”.

This NCMI report was “briefed multiple times to" the Defense Intelligence Agency, the Pentagon’s Joint Staff, and the White House”. By this account, the briefings began at the end of November. The sources for the ABC story also say this report went on to policymakers and decision-makers throughout December. [Correction made here ³]

Open secrets - who else knew?

The spies were not the only ones who knew about the outbreak before the Chinese told the world on December 31st. It turns out that many academics knew. That first came into focus in April 2020 when, buried in an article in the Financial Times, Ian Lipkin, an epidemiologist from Columbia University--who worked on the first SARS epidemic--remarked that he first learned about it from colleagues in China in mid-December.  Dr Lipkin has recently confirmed this and put a date on it.

In the last few days, a new documentary dated this knowledge to December 15th. Ian Birrell of the Sunday Mail has an account. Dr Lipkin says he was tracking the disease with colleagues at the Centre for Disease Control and national government that month.

Others outside of China seem to have known something was going on. An Internet researcher called The Seeker, notes that Ron Fouchier, a virologist from Erasmus MC in Rotterdam, says he heard about the outbreak in the “first week” of December. I was recently speaking to a Dutch journalist⁴ who pointed me to Dr Fouchier’s interview in the program ‘Tegenlicht’.  At 1.57:

Reporter: Where were you when you first heard about that crisis in China?

Fouchier: We hear those things really early. And this was just after Sinterklaas that there were outbreaks of an unknown disease in Wuhan.

Sinterklass, the Christmas holiday, can be any day after December 5th.

At this stage, it seems likely that virologists were hearing about an outbreak of unexplained pneumonia cases. Alina Chan, a postdoc at the Broad Institute, in Boston, tweets that Dutch scientists heard about pneumonia cases in “early December” and it “took 2-3 weeks before they knew it was a coronavirus (last week Dec).” We also know that local doctors were so concerned about the outbreak, and that they were dealing with something new, that they were sending samples off for sequencing from at least December 24th.

And to get a sense of the scale of the chatter, there are unconfirmed reports worth considering, too. A Yale professor tweets, “there were American doctors visiting the Wuhan hospital in mid-December and they were aware of an outbreak of uncharacterized pneumonia at the time”. Another tweet says Lawrence Gostin, a professor at Georgetown University in DC, had heard from a friend in Wuhan in mid-December about a novel coronavirus that looked serious. 

Stitch all this evidence together and it undermines many of the key elements of the Chinese story. It is hard to believe that the head of the Chinese CDC learned of the outbreak from a WeChat group on December 30th. Or that the world’s leading bat coronavirus researcher, based in Wuhan, didn’t find out until she received a call that same evening saying a novel coronavirus had been found in two hospital patients. Or that the first patient case was on December 8th. (That is shown in figure 22 of this report.)

By the middle of December, public schools are closing to “control the spread of disease”, local virologists are consulting foreign scientists about an outbreak of unexplained pneumonia, heck it is even dinner party conversation in Washington, yet all these senior Chinese scientists are oblivious? The staff at the world-leading institute of virology presumably have children. How did a virological novelty that was closing schools escape their notice?

There are plenty of reasons to think that the Chinese are well aware of an outbreak of a novel disease much earlier than they say. Moreover, there is also reason to think that they have now traced cases back into November. According to a story in the South China Morning Post the Chinese government traced the earliest case to November 17th. This newspaper story is also confirmed on a timeline published by America’s Department of Defense. 

Other leaked government documents obtained by CNN suggest the vicious influenza outbreak that was mentioned by ConGen Wuhan might have extended more widely into the province of Hubei, and to the neighbouring cities of Yichang and Xianning. The spike of cases started in the week beginning December 2nd and saw cases rise by about 2,059% compared to the same week the year before.

When the WHO team of scientists went to visit Wuhan in January 2021 they very much wanted to look into the possibility that the virus could have been circulating earlier, perhaps nested within an actual seasonal outbreak of influenza. When they got there they were told the Chinese said they had considered 76,253 respiratory conditions in Wuhan during October and November. But only 92 were compatible with infection with SARS-COV-2, and testing of these samples was negative for SARS-COV-2 antibodies. We don’t know whether the stringent criteria for cases saw many likely cases of covid-19 tossed out. And serological testing so long after the event cannot be relied on. Samples held in blood banks should have been tested but they were not.

To be frank, I can’t say that I trust any of this work given the consistent lack of honesty and transparency there has been from the Chinese on any origin’s related work. I wrote in The Economist last month about how this WHO-led investigation was riddled with compromises and sloppiness, and fundamentally flawed. The long and short of it is that although it would be very revealing to dig deeply into those earlier respiratory cases, this line of inquiry has hit the buffers. The calls for the data on the first 174 cases have gone unanswered.

Yet for there to be so many cases of what would become known as SARS-COV-2 in early December, there had to have been transmission in November. Remember that even only small numbers of potential and confirmed cases in early December would have likely sat on top of a much larger number of asymptomatic cases. 

This is the correct context to consider the reports of cases in Europe (see here), particularly northern Italy, detected in stored patient samples in November (and earlier). (See here, here, here, and here.) Wuhan is well connected to Europe by air, and potentially more so with Milan thanks to the clothing trade. From November 2019, Italian doctors were reporting severe respiratory symptoms in elderly and frail people, with atypical bilateral bronchitis. As in China, this was attributed to an aggressive seasonal influenza.

The detection of pre-December cases by Italian researchers, and a few reports from France, Brazil, and Spain, have been a source of controversy. I don’t think this is the place to go through the scientific arguments about the accuracy of various tests and how lab contamination is a tricky problem. But I think the growing number of these reports suggests a real signal. Don’t trust me, though. Marion Koopmans, a Dutch virologist from Erasmus MC, told Wired recently that “we cannot get around that there are now several pointers from northern Italy”. (Please see update 4 as the thinking on the early Italian samples has changed.)

The Chinese are now circulating a ludicrous theory that early cases overseas mean that the viral outbreak did not start in Wuhan. Anyone who has been paying attention will see that these European cases are a porthole onto what must be a broader lake of undisclosed and unknown cases in Wuhan in November. 

Since the outset of the pandemic, many journalists have pieced together a sorry portrait of Chinese behaviour. Of a country that has consistently withheld knowledge and data on covid-19 and its origins. Whether the virus came from a laboratory, a field worker, or a food chain, China broke agreements with the world that it will promptly disclose an outbreak of a dangerous new pathogen. One important question for the world is whether virologists themselves should also be bound by these rules to inform others. Or whether foreign governments should be bound to report on countries they suspect to have outbreaks.

For what it is worth, I think the virologists--indeed everyone--needs to be more open about what they knew and when. A lot of people have died. Their families deserve answers.

Was the virus spreading through Wuhan’s schools in November?

It is worth highlighting the issue of the school closures in Wuhan. Today we know that covid-19 does not affect children as badly as adults, and often occurs asymptomatically in kids. School closures in mid-December suggest that the authorities were aware schools were aiding the spread of disease--we don’t know if they knew it was influenza or something else by this stage.

It is time to introduce a young man called Connor Reed, from North Wales. He was living and working in Wuhan at the end of 2019 when he became the first British person to catch what would become known covid-19. His first symptoms of sickness, cold-like symptoms, were on November 25th. By day 9, his kitten is under the weather and isn’t eating (cats can catch covid-19). By day 11, the cat is dead.

The next day Mr Reed describes feeling as though he is suffocating, and says his lungs sound “like a paper bag being crumpled up”. He gets into a cab and travels to Zhongnan University Hospital.

As soon as I get there, a doctor diagnoses pneumonia. So that’s why my lungs are making that noise. I am sent for a battery of tests lasting six hours.

The next day he arrives home and slowly recovers. On day 36 (December 30th) he heads to the shops to stock up on food when he hears that “Chinese officials are concerned about a new virus that is taking hold in the city. There are rumours about a curfew or travel restrictions”. Fifty-two days after his infection the hospital gives him a diagnosis⁵. He is told he has the new coronavirus. In March 2020, he wrote about his illness in this piece for The Mail and wonders if he caught it at the fish market.

Maybe I caught the coronavirus at the fish market. It’s a great place to get food on a budget, a part of the real Wuhan that ordinary Chinese people use every day, and I regularly do my shopping there.

It is certainly possible that Mr Reed caught the virus there. Although that theory is not aided by the fact that the Chinese say the earliest case was not until much later, on December 10th. There is another possibility.

Another British man in Wuhan, Jamie Morris, suspects he caught covid-19 in November. Both Mr Morris and Mr Reed were teachers. Another hypothesis is presumably that both men picked it up in one of the schools they were teaching in. Local teachers could have easily carried the infection into the market. It is just an idea. But it is worth considering.

Sadly we can’t ask Mr Reed any more about his time in Wuhan. After accepting a university place in a Welsh university and moving back to Britain, he tragically died after taking a cocktail of illegal drugs⁶ in October 2020.

A quote on his Facebook page reads, “Today was fun. Today has gone. Tomorrow is another one.” Dr Seuss.

Updates

Short updates to this story will be posted here. Please do get in touch if you have any further information about the stories in this newsletter--or comment in the chat. Please let me know if there are any errors of fact in this item.

1. This map by Drastic has a location for Mr Reed’s home.

2. Lawrence Gostin confirmed the account here in an email to me in October 2021. In mid to late December 2019 he became aware of an outbreak of a novel respiratory virus similar to SARS. He heard this via friends in China via WeChat and other communications. “Clearly, it was even then a widely circulating novel virus, reminiscent of SARS”. He says he also told a neighbour, a journalist, about it at the time. (5.3.2023)

3. Another journalist has since told me that Fouchier has since claimed his memory of the date of discovery may be in error. (5.3.23)

4. The sequences of the viruses found in the early Italian samples make it clear that it was lab contamination says evolutionary virologist Stephen Goldstein.

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Acknowledgments- Thank you to my colleague Shashank Joshi who commented on an earlier version of this piece. Any errors are mine. Photo by Clément Falize on Unsplash, with thanks.

Corrections - please see footnotes for correction on the NCMI report. NL. 14.09.21. And a small correction on the terminology around the death of Connor Reed. The spelling of Dr Seuss has been corrected.

1. The first case of covid-19 stated by the Chinese was initially said to be December 1st. I learned from a WHO spokesperson this was reclassified as a December 26th case. The patient was among an: “initial cluster detected on 26-27 dec. he was already sick on dec 1 but it was reassessed as being something else starting 1 dec and then he got covid later in dec and onset of symptoms on dec 26. He had some underlying disease”.

In other words, the patient was sick on December 1st, but later it was decided this was not with covid-19. That certainly explains the mystery but it will not convince everyone. (I’m sure I’m convinced.)

2. A well-sourced timeline can be found here: https://sensehofstede.nl/timeline-of-the-covid-19-outbreak

3. At this point, my piece originally said: “The director of the NCMI has denied that this report exists. If this report exists, would the authors have spoken to ConGen Wuhan in November? Hard to see that they could not have done so.”

With thanks to Drastic’s Gilles Demaneuf for this correction and observation, 14/09/21. “The direction of the NCMI did NOT deny that the report existed. They denied that a report was available in November. On the 2nd week on Nov NCMI started picking up data points that made it to 'situation reports'. In intel parlance these are not products. Product means intel assessment. The product, meaning a properly reviewed assessment that went up the intel chain, was available in Dec. But the NCMI usual consumers, the US Army, alerted NATO and the IDF (Israeli Army) by the ned of Nov.

https://www.researchgate.net/publication/354462471_notes_When_did_the_US_learn_about_the_Wuhan_outbreak/stats

4. With thanks to Frederick Mansell

5. In this piece for the Mail, https://www.dailymail.co.uk/news/article-8922933/Mystery-death-Briton-revealed-Covid-cover-up.html, it is reported that Mr Reed broke the news of his diagnosis on Facebook. There is no record of this on his Facebook page. The most recent post on this page is dated 30th January 2019.

6. This death was originally stated here as due an “overdose” and has been corrected to reflect that the death could well have been due to the mix of drugs, rather than the quantity.