夏荷冰語
用眼睛去發現，用耳朵去傾聽，用心靈去感受，體驗別樣的人生。
【《財新》獨家披露：冠狀病毒· 早期發現· 官方抑製·傳播全球】
｛深入探討：如何發現，傳播和抑製類似於SARS的病毒的早期跡象｝
In Depth: How Early Signs of a SARS-Like Virus Were Spotted, Spread, and Throttled
參與報道記者：高瑜，彭豔峰，楊銳，馮玉鼎，馬丹夢，弗林·墨菲，韓偉和沈慧敏
出版時間：2020年2月28日；《財新》
《財新》調查顯示，這種新的冠狀病毒已經在中國實驗室進行了測序，這種病毒已經奪走了將近3000條生命，並傳播到了近50個國家，並被發現與SARS類似。 找到了。
12月，來自多個實驗室的測試結果表明爆發了新病毒。 然而，盡管被送入旨在向中國高級衛生官員警告疫情爆發的傳染病控製係統中，結果仍未能引起公眾的反應。
這些揭示表明，衛生官員如何在爆發的最初階段錯過了控製病毒的早期機會，因為關於誰知道什麽時間，何時知道這些行動是否有助於疾病傳播的問題越來越多。
早在12月27日，一家位於廣州的基因組學公司就從一名65歲送貨員的肺部液體樣本中測序出了大部分病毒，該送貨員在海鮮市場工作，其中出現了許多頭例病例。 結果顯示與致命SARS冠狀病毒的驚人相似之處，後者在2002年至2003年之間導致近800人死亡。
大約在那個時候，當地醫生從武漢附近的醫院向至少包括中國重量級BGI在內的多家中國基因組學公司發送了至少八份其他患者樣本，他們致力於確定越來越多的原因不明的呼吸道疾病背後的原因。 結果全部表明是一種危險的SARS樣病毒。
就在幾天前，中國於12月31日通知世界衛生組織（WHO）出現了一種未知的傳染病，距它與世界共享該病毒的基因組序列還有兩周，而至關重要的是，距中國當局確認已超過三周 公開指出該病毒正在人與人之間傳播。
有關這種新疾病的擔憂最初是由一小部分醫務人員，研究人員和官員負責的。 12月30日，李文亮博士是武漢市最早響起警報並在網上發布初步證據的人之一。 因發布信息而受到懲罰的李在感染患者後五周後將死於該病。
1月1日，幾批基因組序列結果返回醫院並提交給衛生部門後，一家基因組公司的員工接到了湖北省衛生委員會官員的電話，命令該公司停止測試樣品。 來自武漢的與新病有關的疾病，並銷毀了所有現有樣本。 該員工不願透露姓名，並說要立即停止發布測試結果和有關測試的信息，並向當局報告任何將來的結果。
然後在1月3日，中國國家最高衛生主管部門國家衛生委員會（NHC）下令，機構不得發布與未知疾病有關的任何信息，並下令實驗室將其必須攜帶的任何樣品轉移至指定的檢測機構，或銷毀這些樣品。 他們。 財新看到的命令沒有指定任何指定的測試機構。
世衛組織流行病學家布魯斯·艾爾沃德（Bruce Aylward）在周二在北京舉行的新聞發布會上解釋了疫情的發生過程和應對措施。
照片：CGTN
1月9日，中國當局最終宣布，武漢市爆發了病毒性肺炎，這是一種新型冠狀病毒。 即使到那時，該病毒的傳播能力也被低估了，使公眾仍未意識到迫在眉睫的危險。
最終，在1月20日，呼吸衛生方麵的領導機構鍾南山在抗擊非典的過程中引起了全國關注，他在電視采訪中證實該疾病正在人與人之間傳播。
兩天後，擁有一千一百萬人口的武漢被封鎖。 今天它仍然被隔離。
社交媒體帖子提供了線索
最早的結果是在武漢海鮮市場工作的一名65歲送貨員，該結果於12月27日由視覺醫療公司（Vision Medicals）返回，該公司位於中國廣東省廣州市黃埔區，是一家基因組公司。
該患者於12月18日因肺炎入武漢市中心醫院，病情迅速惡化。 醫院呼吸內科負責人趙蘇說，12月24日，醫生從他的肺部抽取了液體樣本，並送往Vision Medicals進行測試。
該公司沒有回傳結果，而是在12月27日給醫生打電話。“他們隻是打電話給我們，說這是一種新的冠狀病毒，”趙說。
Vision Medicals證實測試是在上周晚些時候在社交媒體上發布的帖子中進行的。 該帖子稱，該公司參與了對新冠狀病毒的早期研究，並為在《中國醫學雜誌》英文版上發表的有關其發現的文章做出了貢獻。 該文章特別提到了12月24日從一名與海鮮市場接觸過的65歲患者那裏收集的樣本。
據信由Vision Medicals員工撰寫的另一篇社交媒體文章進一步闡明了該公司的早期工作。 該帖子的作者於1月28日發表，隻說他們在Vision Medicals所在地廣州黃埔的一家私人公司工作。
該帖子的作者說，他們在12月24日收集的樣本的測試結果中注意到與SARS冠狀病毒非常相似，但由於其重要性，他們決定在返回結果之前進行更仔細的研究。 文章稱，該公司確實與中國醫學科學院共享數據。
文章說，在12月27日，實驗室工作已經對該病毒的大部分基因組進行了測序，並確認它是一種類似於SARS病毒的冠狀病毒。
文章說，在接下來的幾天裏，公司高管訪問了武漢，與當地醫院官員和疾病控製部門討論了他們的發現。 它說：“正在進行深入而機密的調查，醫院和疾病控製中心的官員已經承認了許多類似的病人。”
有關此早期研究的很少信息已正式發布。 該患者轉入武漢市金銀塘醫院，隨後死亡。
中國科學院武漢病毒研究所。 圖片：丁剛/蔡欣
由“小錯誤”觸發的啟示
在Vision Medicals的研究人員對他們的發現進行思考的同時，武漢市中心醫院將另外兩名神秘肺炎患者的拭子送往位於北京的實驗室CapitalBio Medlab Co. Ltd.進行研究。
其中一個樣本來自一名沒有與海鮮市場接觸史的41歲男子，他於12月27日入院。
該公司提供的測試結果顯示
對SARS的誤報。 基因測序專家告訴財新，這是一個“小錯誤”，可能歸因於基因數據庫有限或缺乏重新測試。
但是，正是這個錯誤引發了公眾的首次關注-回憶起17年前定義SARS爆發的掩蓋事件的痛苦回憶。
12月30日晚，武漢的幾位醫生，包括已故的李文亮在內，私下分享了CapitalBio的結果，以警告朋友和同事采取保護措施。 這些消息隨後在網上廣泛傳播，並引發了公眾的騷動，要求提供更多信息。 包括當天晚上發送郵件的李和其他兩名醫生在內的幾人後來因“散布謠言”而受到當局的懲罰。
湖北新華醫院呼吸科主任張繼賢於12月26日注意到，他從附近的海鮮市場接獲越來越多的肺炎症狀患者。 他於第二天向醫院報告了情況，並將報告轉交給市和省級衛生部門。
根據這些報道，武漢和湖北的疾病控製部門於12月30日發出內部通知，警告出現肺炎患者，這些患者與海鮮市場有關，並要求醫院進行監測。
該通知隨後在網上泄漏，使公眾對官員們對此次疫情的承認有了第一眼的印象。
靜音警報
財新獲悉，其他幾家基因組公司也在12月下旬在武漢對當時不明病毒的患者樣本進行了測試。
行業領導者BGI於12月26日從武漢一家醫院收到了一個樣本。測序已於12月29日完成，並顯示雖然不是引起SARS的病毒或嚴重的急性呼吸道綜合症，但它是以前看不見的冠狀病毒 80％與導致SARS的病毒相似。
BGI的一位消息人士告訴《財新》，當他們在12月下旬進行測序項目時，該公司並未意識到該病毒已經使許多人患病。 消息人士說：“我們每天都要接受大量的測序委托。”
財新了解到，武漢醫院於12月份向華大基因送出了至少30份來自不同肺炎病例的樣本進行測序，發現其中3份含有新的冠狀病毒。 除了12月26日的病例外，12月29日和12月30日還收到了第二個和第三個陽性樣本。它們一起進行了測試，並將結果最早於1月1日報告給武漢市衛生委員會。
一位員工說，1月1日，基因測序公司接到了湖北省衛生委員會的命令，要求停止測試並銷毀所有樣品。該人士說：“如果您將來進行測試，請務必將其報告給我們。”
兩天後的1月3日，國家衛生委員會發布了堵嘴令，並稱武漢肺炎樣本需要作為高致病性微生物處理-任何樣本都必須移至認可的檢測設施或銷毀。
一位病毒學家告訴《財新》雜誌，甚至連中國科學院武漢病毒研究所（WIV）也沒有資格進行測試，並被告知要銷毀實驗室中的樣品。
但是那天，上海複旦大學的張永珍教授從武漢市中心醫院收到了用幹冰裝在金屬盒中並通過鐵路運輸的生物樣本。 到1月5日，張的小組還通過高通量測序鑒定了新型的SARS樣冠狀病毒。
張向上海市衛生委員會和中國國家衛生委員會報告了他的發現，警告新病毒類似於SARS，並通過呼吸道傳播。 1月6日，這引發了中國疾病預防控製中心（CDC）的第二次應急響應。
據中國國家廣播電視台CCTV報道，1月9日，由疾病預防控製中心領導的專家小組初步得出結論，該病是由一種新的冠狀病毒引起的。
1月11日，張的團隊率先在公共數據庫Virological.org和GenBank上發布了該新病毒的基因組序列，並首次向世界展示了其結構。 NHC次日與世界衛生組織共享了病毒基因組信息。
同樣在1月11日，武漢市衛生委員會在暫停報告數天之後，恢複了更新新病毒的感染病例。 但是政府再次宣稱沒有醫務人員感染，也沒有人傳播的證據。
同時它報告說，確診病例已降至41 例。
聯係記者Flynn Murphy（flynnmurphy@caixin.com），Han Wei（weihan@caixin.com）和Timmy Shen（hongmingshen@caixin.com，Twitter：@timmyhmshen）和編輯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
