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WHO should investigate Wuhan Metro Line 2 for spread of COVID-19 pandemic

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In its Global Investigation Report – Origins of SARS-Cov 2, the World Health Organisation (WHO) stated that the seafood market in Wuhan City was the source of this Coronavirus outbreak or played a role in the initial amplification of the outbreak.

Speaking on the report, Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO said, “The team has confirmed that there was widespread contamination with SARS-CoV-2 in the Huanan market in Wuhan, but could not determine the source of this contamination.”

However it is interesting to note that a research paper of Dr Steven Carl Quay in 2019 at the onset on the pandemic in China had opined that the COVID-19 pandemic began at the PLA Hospital and early human-to-human transmission of the COVID-19 on the Wuhan Metro Line 2. The paper titled ‘Where Did the 2019 Coronavirus Pandemic Begin and How Did it Spread?

Dr. Quay is the head of two COVID-19 therapeutic programs at Atossa Therapeutics, Inc.

Dr Quay moots that The People’s Liberation Army Hospital in Wuhan China and Line 2 of the Wuhan Metro System Are Compelling Answers

In the research paper, Dr Quay elucidates:

The origin of the SARS-CoV-2 coronavirus that has caused the COVID-19 worldwide pandemic remains unknown. Here I report that the earliest genomic cluster is a group of four patients associated with the General Hospital of Central Theater Command of People’s Liberation Army (PLA) of China in Wuhan. This cluster contains the “Founder Patients” of both Clade A and Clade B, from which every SARS-CoV-2 coronavirus that has infected every patient with COVID-

19 anywhere in the world has arisen, including the infection of the President of the United States.

The observation that the genomic files for these patients were created on December 10, 2019 but the PLA Hospital did not record the collection of the specimens until weeks later is unusual and unexplained. However, it would be consistent with a vaccine challenge clinical trial (in which case files are set up in anticipation of getting samples later) or it suggests that the collection dates were actually before December 10, 2019 (in which case the reported dates for specimen collection are not accurate but may have been recorded incorrectly to suggest the infection was spreading later than it really was).

The PLA Hospital is about one mile from the Wuhan Institute of Virology (WIV) and the closest hospital to WIV. Both the PLA Hospital and WIV are serviced by Line 2 of the Wuhan Metro System. The Hunan Seafood Market is also located adjacent to Line 2.

All patients between December 1st, 2019 and early January 2020 were first seen at hospitals that are also serviced by Line 2 of the Metro system. With hospitals located near seven of the nine Metro Lines, the likelihood that all early patients were seen at hospitals only near Line 2 by chance is about 1 in 68,500 (p-value = 0.0000146). The inference then would be that the early spread of SARS-CoV-2 was through human-to-human infection on Line 2. Line 2 connects to all eight other lines of the Wuhan Metro System (1, 3, 4, 6, 7, 8, 11, and Yanglu) facilitating rapid spread in Wuhan and Hubei Province, and also services both the high-speed rail station (Hankou Railway Station), facilitating rapid spread throughout China, and the Wuhan International Airport (Tianhe International Airport), facilitating rapid spread throughout Asia, Europe, and to the United States.

In fact, direct human-to-human spread from the Reference Sequence patient to patients around the world is suggested by an unexpectedly reduced genome base substitution rate seen in patient specimens in cities with direct flights from Wuhan.

In conclusion, Line 2 of the Wuhan Metro System services the PLA Hospital with the first genomic cluster of patients with COVID-19, the hospitals where patients first went in December 2019 and early January 2020, and is the likely conduit for human-to-human spread throughout Wuhan, China, and the world.

The Hunan Seafood Market, Wuhan Institute of Virology, and the Wuhan CDC, all locations suggested to be the possible source of SARS-CoV-2 in Wuhan, are also all serviced by Line 2 of the Metro system, suggesting this public transit line should become the focus for further investigations into the origin of this pandemic.

Dr. Quay further states, “Since the outbreak, searches for the intermediate host or the ultimate bat host have been exhaustive but fruitless. At this point, the local wet market, farmed animals in Hubei province, indigenous bats in Hubei province, and the rare, endangered pangolin have all been considered but ultimately ruled out by Chinese scientists and the Chinese CDC.

At the same time, hypotheses that this arose from an accidental release from a laboratory,

predominantly attributed to the Wuhan Institute of Virology (WIV), have been rampant. The early, December 2019 and January 2020 volume of criticism of the zoonotic origin theory led to the unprecedented publication in the Lancet of a paper by the ‘who’s who’ of virology, stating that an unsubstantiated hypothesis that the virus was the accidental release from a laboratory was a ‘conspiracy theory.’ Unfortunately, the few published reports of early patients in Wuhan in late 2019 and early 2020 are conspicuous in the absence of information of the name of the hospitals where patients were first seen or were transferred between.”

Another important fact that Dr. Quay brings out in his research paper was the earliest genomic cluster had been identified as four patients associated with the People’s Liberation Army (PLA) Central Theater Command Hospital in the Wuchang District of Wuhan. The ENA archive file creation date (stamped by the ENA server in the EU) for these four patient’s specimens was on December 10, 2019, which is over two weeks before the specimens were actually collected. At this early date, according to Chinese authorities, there were only four reported cases anywhere in China. A random selection of other COVID-19 patient ENA files shows no examples of a file creation date before a sample collection date. One conclusion from this observation is that the specimens were actually collected before December 10.

Dr. Quay further states, that the PLA hospital is only three kilometers from the Wuhan Institute of Virology and both the PLA Hospital and the WIV are located on Line 2 of the Wuhan Metro System. All patients admitted anywhere in Wuhan with SARS-CoV-2 between December 1, 2019 and January 5, 2020 were at hospitals along Line 2, suggesting a likely route of spread. The probability of these hospitals being on Line 2 by chance is one in 68,500. Line 2 carries an average of one million passengers per day and importantly, the last and most western station of Line 2 is the Tianhe International Airport, with regular flights to New York City,San Francisco, London, Tokyo,Rome, Istanbul, Dubai, Paris, Sydney,Bali, Bangkok, Moscow, Osaka,Seoul, and Singapore.

 

Line 2 is the busiest line in Wuhan and was carrying one million passengers a day before the pandemic. Assuming most commutes are daily round trips, about 5% of Wuhan’s entire population travelled on this Line each business day. One sick passenger coughing and making aerosols or droplets that can remain airborne for hours could literally infect tens or hundreds of thousands of fellow riders. And because every other Line shares a station with Line 2, spreading to all of Wuhan and then Hubei Provence from a Line 2 contagion was inevitable, Dr Quay opined.

The Line 2–Tianhe Airport-World connection is supported by the appearance of  “pairs” and near pairs in countries with non-stop airline service from Wuhan according to Dr Quay’s research.

Dr. Quay believes based on his research that it is important investigations into the origin of the SARS-CoV-2 pandemic should focus on potential locations on Line 2 of the Wuhan Metro System. The moot question that remains however is whether the WHO will adopt this line of investigation in the origins of SARS-CoV-2.

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