The Nine Great Covid Mysteries

DEBATES ON COVID - VACCINES, 20 Jun 2022

Swiss Policy Research - TRANSCEND Media Service

June 2022 – The nine great Covid mysteries: from virus origins to the Nordic paradox.

Coronavirus vs. influenza virus (PN)

1) Coronavirus origin

The genetic evidence strongly suggests that SARS-CoV-2 has a lab-related origin. This is due to various unique genetic properties relating to the so-called furin cleavage site (FCS), such as a CGG-coded double-arginine codon (the “smoking gun” according to Nobel Prize winning US virologist David Baltimore), an amino acid sequence identical to the human alpha-ENaC protein subunit, and a so-called Golden Gate seamless cloning site right next to the FCS. In addition, large investigations both inside and outside of China found no animal origin of SARS-CoV-2.

Such a lab-related origin is consistent with a lab leak either in China or in the US, or with a deliberate release of the virus (similar to the 2001 US anthrax letters). Indeed, leaked documents show that in the years prior to the 2019 outbreak, the Wuhan Institute of Virology (WIV), several US labs, and Pentagon contractor “EcoHealth Alliance” were working on, or considering, the insertion of an FCS into SARS-related coronaviruses to “defuse the threat of bat-borne coronaviruses” (project DEFUSE).

Claims that SARS-CoV-2 is unlikely to have a lab origin (by some US/Western virologists linked to NIAID director Dr. Anthony Fauci), or that a lab leak could only have occurred in Wuhan (e.g. by former British intelligence chief Richard Dearlove), are scientifically unfounded or deceptive.

Figure: US and Chinese coronavirus researchers at a 2018 symposium in Wuhan

US and Chinese coronavirus researchers at a 2018 symposium in Wuhan (CAS)

2) 2019 US respiratory disease wave

In mid to late 2019, the US experienced several mysterious and unresolved events that may or may not be linked to each other and to the origin of SARS-CoV-2.

For instance, in early July 2019 the US CDC closed the biodefense research lab at Fort Detrick over “containment breaches” and “safety concerns”.

Also in July 2019, some nursing homes in northern Virginia, about 50 miles from Fort Detrick, reported an outbreak of a “mystery respiratory disease”, typically “starting with a cough”, that claimed several lives. At the time, the US CDC could not identify the pathogen causing the respiratory disease. In 2020, both the CDC and the nursing homes turned down requests to re-investigate the pathogen that caused the mysterious outbreaks.

Beginning in June 2019, the US experienced a mysterious wave of respiratory disease, later termed “EVALI”, with symptoms almost identical to covid, including pneumonia even in young people. The official explanation of “vitamin E acetate” as a filler in illegal THC vapes was not convincing, as the addition of this substance hadn’t been a new phenomenon. Moreover, “EVALI” essentially disappeared in parallel to the onset of the covid pandemic in early 2020. Nevertheless, the CDC never (publicly) re-investigated the 2019 “EVALI” cases for the presence of SARS-CoV-2.

On 18 October 2019, the Military World Games were held in Wuhan, during which several participants contracted a covid-like disease, according to later reports. China would later argue that SARS-CoV-2 may have been imported to Wuhan by US participants of the military games.

Also on 18 October 2019, a one-day coronavirus pandemic simulation exercise called Event 201 was held in New York City. The event was organized by the Johns Hopkins University Center for Health Security and was sponsored by the Gates Foundation and the World Economic Forum.

When doctors in Wuhan noticed unusual cases of pneumonia in young people, they quickly suspected that this could be another SARS coronavirus outbreak. In contrast, when US doctors noticed very similar cases a few months earlier, they first thought of illegal drugs.

Figure: July 2019 nursing home respiratory disease outbreaks and US military biolabs

July 2019 nursing home respiratory disease outbreaks and US military medical labs (source)

3) The Wuhan lockdown

The ostensible success of the Wuhan lockdown in January 2020 was instrumental in justifying the many failed and highly disruptive lockdowns in other countries. Only in 2022 did China impose new lockdowns on major cities such as Shenzhen, Shanghai and Beijing.

Did the Wuhan lockdown in January 2020 really end coronavirus infections in the city, or did the covid winter wave in Wuhan simply end by itself, as it did in many other countries? But why did covid not return to Wuhan in 2020 or 2021, in contrast to most other countries? And why did coronavirus spread internationally, but not, initially, within China, despite the fact that Wuhan was a travel hub during the Chinese New Year in January 2020? By spring 2020, less than 5% of Wuhan citizens had SARS-CoV-2 antibodies, compared to about 25% of citizens in New York City.

Furthermore, who was behind the creation and distribution of the fake videos and photos supposedly showing coronavirus-infected people “keeling over” in the streets of Wuhan? In January 2020, about a dozen of these videos and photos were shared by Western news agencies, major media outlets and on social media, ramping up fear and panic during the early days of the pandemic.

Figure: AFP photograph of a “man dead in the streets of Wuhan”.

“Wuhan: a man lies dead in the street” (AFP/Getty, January 30, 2020)

4) Omicron origin

In November 2021, the so-called omicron variant of SARS-CoV-2 emerged in South Africa. Unlike previous coronavirus variants, the genetic evidence strongly indicates that omicron did not evolve naturally from previous variants, but emerged from virological or vaccine research. In fact, the omicron variant goes back to the earliest coronavirus strain and includes about two dozen mutations mysteriously “copied from scientific publications”. Omicron turned out to be highly infectious and strongly immune evasive, but much milder than previous SARS-CoV-2 variants.

Figure: Non-natural emergence of omicron variant

Non-natural emergence of omicron variant (more)

5) Coronavirus transmission (small-scale)

Initially, most health authorities argued that SARS-CoV-2 is transmitted primarily via respiratory droplets (“wear your mask”) and via object surfaces (“wash your hands”). In reality, these are likely the least important modes of transmission. Instead, indoor respiratory aerosols emerged as the most important mode of transmission, despite denials by most health authorities for over a year.

Aerosol transmission likely explains why face masks and even N95/FFP2 masks (if worn by non-professionals) had essentially no effect on infection rates.

Nevertheless, several important questions concerning modes of transmission remain unsolved.

For instance, why are outdoor infections extremely rare, even if people are standing very close to each other and are singing or shouting? Is it because of aerosol dilution?

Why is infectious virus measurable for hours or even days on many surfaces (in lab studies), but actual infections via surfaces appear to be extremely rare in most real-world studies? Is it because deposition of virus on surfaces is frequent, but infection via surfaces is rare?

Finally, what role does the dreaded fecal-aerosol mode of transmission play (e.g. via public toilets, air conditioning or sewage systems)? It is well known that infectious coronavirus is excreted via stool for longer periods than via respiration, but only China took this potential mode of transmission seriously (e.g. by applying toilet disinfection and the infamous “anal swabs”).

Figure: US mask mandates without benefit

United States: mask mandates without benefit (IanMSC)

6) Coronavirus transmission (large-scale)

Ever since the discovery of influenza virus in the early 1930s, fundamental questions concerning respiratory virus epidemiology have remained unanswered.

During the coronavirus pandemic, it was observed that SARS-CoV-2 fully displaced influenza viruses and many other respiratory viruses. Influenza viruses only returned once a country had achieved a SARS-CoV-2 population infection rate of about 75%, regardless of interventions like face masks or lockdowns. Similarly, new SARS-CoV-2 variants repeatedly displaced previous variants, often within weeks.

Already during previous flu pandemics, new flu strains permanently displaced previous flu strains. How do viral interference and viral displacement work? Why do these viruses not coexist in parallel? There seems to be some kind of “the winner takes it all” principle at work, possibly linked to exponential, aerosol-mediated transmission and host immunity properties.

Seasonality of respiratory virus transmission is also still largely unexplained. Is it driven by temperature, air humidity, vitamin D status or other factors? Why is there seasonality in northern and southern temperate climate zones, but not in tropical and subtropical climate zones? Why do some viruses breach seasonal patterns, such as the swine flu virus in 2009 and the SARS-CoV-2 delta and omicron variants in 2021/2022? It may once again have to do with aerosol transmission and relative infectiousness of a virus.

There are also mysterious virus transmission patterns at continental scales. For instance, in Europe both flu waves and SARS-CoV-2 waves typically start at the western end of the continent (e.g. in Portugal, Spain and Britain) and move eastwards. In the US, SARS-CoV-2 infections have oscillated between states in the southeast (e.g. Florida) and in the northwest (e.g. Washington and Montana). These mysterious but natural patterns caused confusion because, coincidentally, covid vaccination rates were higher in western Europe than in eastern Europe, and higher in northern US states than in southern US states.

Another deep mystery is why respiratory virus infection waves are ending all by themselves, long before having infected the entire population of a country or region. This is a phenomenon that has been known for many decades (or indeed centuries), yet during the coronavirus pandemic, many health authorities falsely believed or asserted that without interventions such as lockdowns, infections would simply continue increasing exponentially. Some researchers have argued that respiratory viruses circulate within social networks (e.g. households and schools), and that transmission breaks down as soon as a network has been exhausted.

Figure: Displacement and return of the flu in India

Flu waves in India (WHO FluNet)

7) The East Asian paradox

Until the arrival of the omicron variant, most East Asian countries and some Southeast Asian countries have avoided major coronavirus waves. In countries like North Korea, South Korea, Singapore and Taiwan, one might argue that this was due to rapid and strict border controls. But this doesn’t explain the case of Japan, which hosted the Summer Olympic Games in 2021 and never introduced any major restrictions on social and business life. It also doesn’t explain the case of Indochinese countries with very low infection and death rates prior to 2022.

Initially, it was believed that face masks made the difference, but face masks failed everywhere else, and they also failed in East Asia with the arrival of the delta and omicron variants. Furthermore, they had failed during previous flu epidemics in East Asian countries.

Another explanation was some kind of pre-existing immunity against coronaviruses similar to SARS-CoV-2. But such pre-existing immunity could never be confirmed, and it wouldn’t necessarily be expected in very urban countries such as Japan, Taiwan and South Korea. Even in Laos, where SARS-related bat coronaviruses originate, a study found cross-reactive (but not necessarily neutralizing) antibodies in only 5% of the general population and in about 20% of people with direct contact to bats and wildlife.

Other explanations include genetic or metabolic differences. For instance, it has been noted that the countries most resilient against SARS-CoV-2 are the very countries with the lowest obesity rates in the world, whereas countries with high obesity rates were most severely affected by covid (e.g. in Europe and the US, Latin America, South Africa and Arab countries), unless they benefited from strict border controls (e.g. Australia, New Zealand, Canada). Indeed, obesity may contribute not just to coronavirus disease, but also to coronavirus transmission (via higher viral loads and higher levels of bioaerosols).

Whatever the cause or the causes of the paradox, the highly infectious and immune-evasive omicron variant eventually overwhelmed even East Asian countries.

Figure: Mask compliance and infections in Taiwan

Mask compliance and infections in Taiwan (IanMSC)

8) The Scandinavian paradox

The Scandinavian or Nordic paradox is not about no-lockdown Sweden, as Sweden showed a pandemic excess mortality very similar to (or even lower than) other countries in Western Europe. Thus, Sweden neither “failed” nor did it have the “lowest excess mortality in Europe”.

Rather, the Scandinavian or Nordic paradox is about the very low pre-omicron covid infection and death rates in other Nordic countries, i.e. Iceland, Denmark, Norway and Finland. The paradox arises because during most of the pandemic, these countries had fewer domestic restrictions than most other Western countries, including Sweden.

It could be argued that in all of these countries, remote geography and early border controls, supported by preemptive lockdowns, may have played a key role in keeping domestic infections at very low levels. In addition, Iceland, Norway and Finland (but not Denmark) have by far the lowest population weighted densities among European countries (about four times lower than Sweden, which is quite similar to other European countries, such as Belgium and Germany). This might have helped slow down domestic coronavirus transmission.

Figure: Covid mortality in European countries

Covid mortality in European countries (OWD)

9) Covid and Kids

In contrast to many other virus infections, children have been least affected by SARS-CoV-2. Moreover, prior to delta and omicron, small children had a significantly lower infection and transmission rate than adults, as the transmission rate increased linearly with age up to the age of 20.

It has been proposed that lower expression of ACE2 cell receptors or a different immune response might have explained these differences, but the question has never really been settled. One may also wonder if the lower transmission rate in (Western) children and in East Asian people (prior to omicron) may have had the same biological cause.

At any rate, the fact that covid generally remains mild in children, and that schools were not “drivers of the pandemic”, means that school closures were one of the worst blunders of the pandemic response.

Figure: Lower covid infection/transmission in children (pre-delta/omic

Population share and contribution to covid infections per age group in the US (Monod, Science, March 2021)

See also

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