To stop the next pandemic, we need to unravel the origins of COVID-19

Abstract

We find ourselves ten months into one of the most catastrophic global health events of our lifetime and, disturbingly, we still do not know how it began. What’s even more troubling is that despite the critical importance of this question, efforts to investigate the origins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and of the associated disease, coronavirus disease 2019 (COVID-19), have become mired in politics, poorly supported assumptions and assertions, and incomplete information. To avoid or mitigate the dire consequences of this and future pandemics (here, people in PPE bury a victim in Delhi, India in June), unraveling the origins of SARS-CoV-2 and COVID-19 will be essential—even though a definitive answer may be elusive, and an objective analysis means broaching some uncomfortable possibilities. Image credit: Shutterstock/PradeepGaurs. SARS-CoV-2 is a betacoronavirus whose apparent closest relatives, RaTG13 and RmYN02, are reported to have been collected from bats in 2013 and 2019, respectively, in Yunnan Province, China (1). COVID-19 was first reported in December 2019 more than 1,000 miles away in Wuhan City, Hubei Province, China. Beyond these facts, the “origin story” is missing many key details, including a plausible and suitably detailed recent evolutionary history of the virus, the identity and provenance of its most recent ancestors, and surprisingly, the place, time, and mechanism of transmission of the first human infection. Even though a definitive answer may not be forthcoming, and even though an objective analysis requires addressing some uncomfortable possibilities, it is crucial that we pursue this question. Preventing the next pandemic depends on understanding the origins of this one. There are several potential origin scenarios. First, SARS-CoV-2 may … [↵][1]1Email: relman{at}stanford.edu. [1]: #xref-corresp-1-1