The team of international scientists that went to Wuhan in January to probe the origins of the Covid-19 pandemic, flew out a month later into a storm of criticism, as well as remaining questions about the source of the virus and China’s cooperation with the investigation.
Another issue coming to prominence is the limited official authority the World Health Organization has in running such an investigation in a sovereign nation.
It has been a week since the team held a press conference in Wuhan, the city where the virus was first identified in late 2019. A WHO official at the event called a theory that the virus may have escaped from a laboratory there “highly unlikely” and appeared to lend credence to another, promoted by Beijing, that it could have arrived on imported frozen goods.
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In the days since, the American and British governments have questioned the findings, with the US saying China had not provided the transparency needed. Team members in media interviews have explained some limitations to the scope of their mission and WHO chief Tedros Adhanom Ghebreyesus has come out to assure that “all hypotheses” about the virus origin remain under consideration.
As the WHO navigates the fallout, all eyes are on the official reports by the Wuhan team – the first is expected to be released this week and a final report later. Global health experts say much is riding on their contents.
“Transparency, transparency, transparency. That’s the name of the game,” said Ayelet Berman, lead in global health and governance at the National University of Singapore’s Centre for International Law.
“The only way to gain any level of credibility is for the report to be as detailed as possible, supported by original data,” she said.
And whatever data is missing from the evaluations will need to be clearly stated in the report, according to health governance expert and professor Sara Davies of Australia’s Griffith University.
“Some of the [international team] members have been upfront in talking about what they got access to and what they didn’t … the report can’t not include that now,” she said.
“This might be the opportunity to [go into] more detail and explain the hypotheses in a way that can’t always be captured at a press conference.”
The team said last week that they concluded it was “most likely” the Sars-CoV-2 virus causing Covid-19 originated in a bat and infected humans via an intermediary animal. But they did not come to a conclusion on how or where that happened – something experts say could take years to achieve, if at all.
But questions have been raised about limited access to information in China that could help in the search.
Blood bank samples from November 2019, which could allow researchers to understand the spread of the disease around Wuhan prior to the first documented cases, have not yet been accessed and were not made available, according to team member virologist Marion Koopmans.
WHO team leader Peter Ben Embarek in an interview with Science magazine also said Chinese and international teams debated how to search hospital records for potential early cases. Different criteria may have turned up hundreds more potential cases to investigate than were presented, he said, noting this was “still planned for the future”.
Meanwhile, though the team said the virus coming from a laboratory accident was “extremely unlikely”, Ben Embarek told Science that the team was not mandated or equipped for a formal audit of the Wuhan Institute of Virology, which conducted research into bat coronaviruses.
The lab leak theory was one promoted by the former Donald Trump administration, though no evidence was ever provided to back it up.
Trump last year said the US would leave the WHO over concerns the organisation was not holding China accountable for the outbreak. The decision was reversed last month after US President Joe Biden entered office.
But Biden’s national security adviser Jake Sullivan on Saturday expressed concerns about the WHO mission’s initial findings and called on China to “make available its data from the earliest days of the outbreak”.
Britain backed the US stance, with Prime Minister Boris Johnson on Monday saying that world powers should sign a global treaty on pandemics to ensure proper transparency.
Beijing has pushed back strongly on the lab escape assertions, a theory that many scientists have also said is unlikely.
Chinese officials have repeatedly stressed the country’s support of the WHO and the mission, despite its start over a year after the outbreak was identified and criticisms about a lack of transparency around its own origins research.
Experts stress that the WHO has limited ability to push China for more data or access – whether for an audit of Wuhan laboratories or open access to patient data – under international law.
“The WHO does not have any formal legal powers to force China to provide such data,” said National University of Singapore’s Berman.
“From the public’s perspective, the WHO comes out looking weak … [but] there’s a gap between what the public expects and the reality of the WHO’s legal powers,” she said.
Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University in the US, said the “timing and terms of the WHO inquiry” showed why the UN body needed greater powers.
“At present, the US and the rest of the world must rely on WHO to negotiate access in an open and fair way,” he said, adding the US should advocate for granting the UN body “more power to independently verify officially reported information about novel diseases”.
But the experts add that there may be limited ability to take action outside of tightening the existing rules – known as the international health regulations – to give the WHO more power relative to states’ sovereign rights.
Mike Ryan, the WHO health emergencies programme director, addressed this in a press conference on Monday in Geneva.
“WHO does not possess the mandate to enter uninvited to any nation state and must show due diplomatic respect to the process of engaging with governments,” he said. “As such this was and remains a collaborative process of discovery between scientists. Clearly there is a political layer on this that has been difficult for all parties to manage.”
As things stand, Griffith University’s Davies says the “carrot approach” may yield better results for the WHO as far as access to data and future field studies in China. The upcoming report, likely to be framed as the beginning of a continued investigation, can be part of that approach, she said.
“If you really want to get the data, you need to demonstrate exactly what is missing and why, in its absence, things can’t be ruled out.”
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