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Sunday, April 19, 2020

Coronavirus: Is there any evidence for lab release theory?

By Paul RinconScience editor, BBC News website

https://www.bbc.com/news/science-environment-52318539

US State Department cables show that embassy officials were worried about biosecurity at a virus lab in Wuhan, China. The lab is in the same city where the coronavirus outbreak first came to the world's attention.

And President Donald Trump has said the US government is looking into unverified reports that the virus escaped from a laboratory.

So what, if anything, does this add to our understanding of the current pandemic?
What do the cables say?

The Washington Post newspaper has reported information obtained from diplomatic cables. They show that, in 2018, US science diplomats were sent on repeated visits to a Chinese research facility. Officials sent two warnings to Washington about inadequate safety at the lab.

The column says the officials were worried about safety and management weaknesses at the Wuhan Institute of Virology (WIV) and called for more help.

It also claims diplomats were concerned the lab's research on bat coronaviruses could risk a new Sars-like pandemic. The newspaper says the cables fuelled more recent discussions in the US government about whether the WIV or another lab in Wuhan could have been the source of the virus behind the current pandemic.

In addition, Fox News has also issued a report promoting the lab origin theory.

Media captionTrump says US is investigating claims that coronavirus originated in a Wuhan lab

The outbreak came to light late last year when early cases were linked to a food market in Wuhan. But despite rampant online speculation, there is no evidence of any kind that the Sars-CoV-2 virus (which causes Covid-19) was released accidentally from a lab.
What kind of security measures do labs use?

Laboratories studying viruses and bacteria follow a system known as the BSL standards, where BSL stands for Biosafety Level.

There are four levels, which depend on the types of biological agents being studied and the containment precautions needed to isolate them.

Biosafety Level 1 (BSL-1) is the lowest and is used by labs studying well-known biological agents that pose no threat to humans.

The containment precautions increase through the levels until you arrive at Biosafety Level 4 (BSL-4) which is the highest, and reserved for labs dealing with the most dangerous pathogens for which there are few available vaccines or treatments: ebola, Marburg virus and - in the case of just two institutes in the US and Russia - smallpox.

The BSL standards are applied internationally, but with some cosmetic variations.

"The Russians, for instance, label their highest containment labs as 1 and the lowest containment labs as 4, so the exact opposite of the standard, but the actual practices and infrastructure requirements are similar," says Dr Filippa Lentzos, a biosecurity expert at King's College London.

But while the World Health Organization (WHO) has published a manual on the different levels, the standards are not enforced by any treaties.

"They've been developed to be in the best interest for working safely, for lab workers who don't want to infect themselves or their community, and for the environment to avoid accidental releases," says Dr Lentzos.

But she adds: "The 'stick' comes with the purse strings. If you want to do projects with international partners they require labs to be operating to certain standards. Or if you have products to sell in the market, or perform certain services, e.g. tests, then you are also required to operate to international standards."

Indeed, the WIV had received funding from the US, along with assistance from American research institutes. The cables recommended giving them even more help.
What kinds of security failures were the cables describing?

The short answer is that we don't know from the information provided in the Washington Post. But, generally-speaking, there are multiple ways that safety measures can be breached at labs dealing with biological agents.

According to Dr Lentzos, these include: "Who has access to the lab, the training and refresher-training of scientists and technicians, procedures for record-keeping, signage, inventory lists of pathogens, accident notification practices, emergency procedures."

But how unusual were the concerns expressed in the diplomatic cables?

Accidents happen. In 2014, forgotten vials of smallpox were found in a cardboard box in a research centre near Washington. In 2015, the US military accidentally shipped live anthrax samples instead of dead spores to as many as nine labs across the country and a military base in South Korea.

There are variations in safety standards across the large number of labs at the lower end of the BSL scale and many lesser breaches don't make it into the news.

But there are relatively few labs that are designated BSL-4. Wikipedia lists over 50 around the world, of which WIV was one, but there is no authoritative list.

They have to be built to very high specifications because they deal with the most dangerous pathogens known to science. As a result, they generally have good safety records. So any concerns about procedures at one of these facilities would be more than noteworthy.
Weren't there previous claims of the virus leaking from a lab?

Yes, almost as soon as the novel coronavirus came to light, there was speculation - much of it uninformed - about its origins.

One online theory, that went viral in January, suggested the virus could have been engineered in a lab as a bioweapon. This allegation has been repeatedly dismissed by scientists, who note that studies show the virus originated in animals - most likely in bats.

Viruses can also be engineered for the purposes of fundamental scientific research. For example, gain of function studies may improve the ability of a pathogen to cause disease, to investigate how viruses could mutate in future.

But a US study of the coronavirus genome published in March found no signs it had been engineered. "By comparing the available genome sequence data for known coronavirus strains, we can firmly determine that SARS-CoV-2 originated through natural processes," co-author Kristian Andersen, from Scripps Research in California, said at the time.

Then there is the allegation of an accidental release of a natural virus from a lab. The proximity of the Wuhan seafood market, where the outbreak came to light, to at least two institutes carrying out research on infectious diseases fuelled speculation about a link.That the WIV had carried out research on bat coronaviruses is a matter of public record. This work was entirely legitimate and published in international journals. Given the country's experience with the Sars outbreak in the early 2000s, this should come as no surprise.

Dr Lentzos said the issue of its origin was a "very difficult question", and added that "there have been quiet, behind-the-scene discussions... in the biosecurity expert community, questioning the seafood market origin that has come out very strongly from China".

But there is currently no evidence that any research institute in Wuhan was the source of Sars-CoV-2.

On Thursday, China foreign ministry spokesman Zhao Lijian addressed the matter at a news conference, telling journalists the World Health Organization's officials "have said multiple times there is no evidence the new coronavirus was created in a laboratory".

President Donald Trump, who has been coming under fire over his administration's response to the pandemic, said that the US government is investigating the lab theory.

China has repeatedly been accused of lacking transparency in the early stages of the outbreak, and Secretary of State Mike Pompeo has said Beijing "needs to come clean" on what they know.

Amid this war of words between the countries, the painstaking - and largely unseen - scientific work to trace the origin of the virus will continue.

Is US coronavirus death toll inflated? Experts agree it's likely the opposite

https://www.usatoday.com/story/news/factcheck/2020/04/17/fact-check-covid-19-death-toll-likely-undercounted-not-overcounted/2973481001/

Fact check: Is US coronavirus death toll inflated? Experts agree it's likely the opposite

Ian Richardson
USA TODAY

Theories have circulated that the government’s system for counting COVID-19 deaths causes inflation in the total number of deaths.

At issue in many cases is the federal guidance for those filling out death certificates. The guidance specifies: “COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to the death.”

Some have interpreted that to mean that deaths will be reported as related to COVID-19 when a person has actually died from something else.

On April 8, Dr. Scott Jensen, a Republican state senator and Minnesota family physician, said on Fox News’ “The Ingraham Angle” that the method of gathering statistics could be “misleading.”

“The idea that we’re going to allow people to massage and sort of game the numbers is a real issue because we’re going to undermine the (public) trust,” he said.

As reported by Forbes, the theory that the U.S. death toll is too high has been espoused on Fox News by talk show host Tucker Carlson, analyst Brit Hume and anchor Harris Faulker.

Claims involving inflated death counts also circulated widely on social media.

On the talk show “Louder with Crowder,” host and commentator Steven Crowder claimed the Centers for Disease Control guidelines could throw off the modeling. He noted the same criteria aren’t applied to infection rates because someone must test positive to be counted as having the virus. The video, posted to Facebook April 10, had more than 1,800 shares as of Thursday afternoon.

“Do you not think for a second that some leftist activist who also happens to work in a hospital in New York is not going to take every single opportunity possible to try and label this a COVID-19 death, if they are not required to actually show any proof of a positive test?” he said.

An April 4 commentary article in the Western Journal titled “CDC tells hospitals to list COVID as cause of death even if you're just assuming or it only contributed” asked how those requirements would affect patients who have several underlying conditions, or those whose symptoms are close to influenza. One user’s Facebook post that shared the article had more than 500 shares.

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"There's no doubt that this guidance will inflate the numbers, the only question is how drastically," the article said.

Meanwhile, misinformation about runaway COVID-19 death reporting has spread widely. Last week, FactCheck.org debunked other viral Facebook posts that claimed "anyone who didn’t die by a gunshot wound or a car accident” is being listed as a COVID-19 death.
How are COVID-19 deaths reported?

As of Thursday afternoon, the CDC had counted 22,871 confirmed deaths due to COVID-19, the respiratory disease that results from the novel coronavirus, and 4,141 probable deaths.

Cases in which a person died from complications of COVID-19, had been tested and was under hospital surveillance are simpler to categorize than other situations, such as when an untested person dies at home and post-mortem testing isn't available.

Guidelines for certifying deaths, published April 3 by the National Center for Health Statistics, instruct hospital staff, medical examiners and other officials responsible for certifying an underlying cause of death to use any available information, such as a person’s medical history, medical records, lab tests and any autopsies.

As the nation faces a shortage of COVID-19 testing, compounded by issues with false negatives in testing and people dying in their homes without positive tests, the National Center for Health Statistics has also established guidelines for certification when testing is not available.

COVID-19 can be reported as a “probable” or a “presumed” underlying cause of death when there can’t be a definite diagnosis. But health professionals must ensure the cause is “suspected or likely” and within “a reasonable degree of certainty" that the virus is responsible. Certifiers should use “their best clinical judgment” and test whenever possible, the guidance says.

On Tuesday, the CDC changed the way it will publish death counts for COVID-19 to include "probable" deaths that may not have a confirmed laboratory test.

Probable deaths must meet criteria based on a combination of epidemiological evidence, clinical evidence and presumptive laboratory testing, or vital records criteria.

Meanwhile, the count of "confirmed" deaths is reserved for those backed up by laboratory evidence, the CDC's website states.

However, just because a person has tested positive for COVID-19 doesn’t mean his or her death will be automatically ruled as stemming from the disease, said Dr. Sally Aiken, president of the National Association of Medical Examiners.

For instance, if a woman ingested something poisonous to take her own life and also had tested positive for the disease, her death would not be attributed to the virus.

“If we determine it to be a suicidal ingestion, we would certify the death as an intoxication/suicide,” she said in an email. “COVID would not be on the death certificate.”
Is the U.S. overcounting COVID-19 deaths? Experts say no

The CDC's changes come as experts say statistics confirmed by positive tests haven't been capturing the full picture of the COVID-19 death toll.

In New York City, the death toll increased by more than 3,700 victims on Tuesday after officials revised counts to include people who were presumed to have had the virus even though the patients never tested positive.

Dr. Jason Farley, a professor of nursing and a nurse practitioner in the division of infectious diseases the Johns Hopkins University schools of nursing and medicine, said New York's example shows the overall number of COVID-19 deaths is likely an undercount, not an overcount.

But he said death statistics reported for hospitalized patients are likely very solid. It's harder to get a handle, however, on the number of people who have died at home of COVID-19 without a positive test, he said.

When people have underlying conditions in addition to COVID-19, physicians will make their best judgment call when declaring the underlying cause of death, he said.

"I think it’s just critical that we understand that clinicians are not sitting there going, 'How can I make this a COVID case when I’m filling out this report?'” he said. "Seeing these patients myself at the hospital at Johns Hopkins, you know who needs oxygen. You know who needs mechanical ventilation.”

Dr. Deborah Birx, coordinator of the White House coronavirus task force, said during an April 8 White House coronavirus briefing that many who succumb to the virus do have other underlying conditions. But that doesn’t mean that they aren’t dying from COVID-19.

"Those individuals will have an underlying condition, but that underlying condition did not cause their acute death when it’s related to a COVID infection," Birx said. "In fact, it’s the opposite. Having an underlying condition and getting this virus, we know is particularly damaging to those individuals."

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, also has pushed back against what he called “conspiracy theories” that the U.S. is overcounting the coronavirus death toll. On April 9, he said on NBC’s "Today" show that there’s “absolutely no evidence that that’s the case.”

“I think the deaths that we’re seeing are coronavirus deaths, and the other deaths are not being counted as coronavirus deaths,” he said.
Our ruling: False

The United States is still getting a handle on how many people are dying of COVID-19. Recent changes in guidance by the CDC are meant to provide a more accurate representation of the count.

Experts say that COVID-19 deaths are likely not being overinflated. That list includes by Dr. Anthony Fauci, who is leading the U.S. response to the coronavirus.

Instead, many experts say the nation is likely amid an undercount of the death toll due to the disease due to factors like false negatives on tests, a lack of testing and people who have died in their homes without receiving a positive test.
Our fact-check sources:
Centers for Disease Control and Prevention: New ICD code introduced for COVID-19 deaths
Centers for Disease Control and Prevention:Guidance for certifying deaths due to COVID-19
FOX News: Minnesota doctor blasts 'ridiculous' CDC coronavirus death count guidelines
Western Journal: CDC tells hospitals to list COVID as cause of death even if you're just assuming or it only contributed
FactCheck.org: Social media posts make baseless claim on COVID-19 death toll
Forbes: A Fox News conspiracy — are coronavirus death numbers inflated? — attacked by Fauci, Birx
The Guardian: Fauci dismisses 'conspiracy theory' of overstated US Covid-19 death toll
The New York Times: Official counts understate the U.S. coronavirus death toll
The New York Times: N.Y.C. death toll soars past 10,000 in revised virus count
Washington Post: Coronavirus death toll: Americans are almost certainly dying of covid-19 but being left out of the official count
Washington Post: A 'negative' coronavirus test result doesn't always mean you aren't infected
CNN: US coronavirus death count likely an underestimate. Here’s why
The White House: Transcript of April 8, 2020, coronavirus briefing
WNYC: Staggering surge of NYers dying in their homes suggests city is undercounting coronavirus fatalities
NBC: Dr. Anthony Fauci: Virus death toll may be 'more like 60,000 than 100,000 to 200,000'

I

Divided Trust on Coronavirus Information in the U.S.

Willem Roper,

Apr 6, 2020

https://www.statista.com/chart/21153/americans-divided-trust-trump-coronavirus-info/

A majority of Americans have little to no trust in President Donald Trump providing accurate information on the ongoing coronavirus in the country and around the world.

In a poll jointly conducted by NPR, PBS NewsHour and Marist, 60 percent of all U.S. adults responded “not very much” or “not at all” when asked whether they trusted the president’s information on the coronavirus. Only 37 percent of Americans responded they had “a good amount” or “a great deal” of confidence in the president.

Predictably, Democrats and Republicans differed in their confidence that Trump would provide accurate information on the coronavirus. While only 8 percent of Democrats had any confidence, 74 percent of Republicans responded that they had confidence in Trump’s information regarding the disease. This corresponded with a separate question in the poll which asked Democrats and Republicans whether they believed the coronavirus was a real threat or blown out of proportion. 76 percent of Democrats responded that they saw the virus as a real threat to their life, while 54 percent of Republicans responded they still believed COVID-19 was blown out of proportion.