Op-Ed: Questioning the ‘Natural’ Origins of COVID

If I avoided moving a muscle, the fatigue during the worst of my COVID-19 illness was not such a problem. Indeed, I felt lucky. My illness began about 3 weeks after my first vaccination, which probably helped protect me. Still, the weakness forced my body to rest, even as it supercharged my mind with questions. As a physician-researcher in the diagnostic imaging sciences, my day job is all about asking questions, and given the horror of the pandemic, one question simply wouldn’t leave my mind: How had this tragedy started?

Like many physicians, I was very aware of the major points in the pandemic’s beginning — the first cases in Wuhan, a loose association with a wet-animal market, frantic Chinese efforts that failed to contain the virus, as well as politically charged questions around research at the Wuhan Institute of Virology.

I had cheered our public health experts, particularly the inspiring NIH leaders, who often endured taunting and belittling questions from right-wing cynics. Still, one story from the NIH had long left me unsettled. Actually, the problem was largely one word in that NIH story. The word was “natural.”

Yes, early in the pandemic, the NIH had reassured the public that scientific evidence strongly indicated COVID-19 had a “natural” origin, likely a zoonotic leap of the virus from bats to humans, as had long been feared. The implication was that chance alone resulted in the first cases occurring not so far from the Wuhan Institute of Virology, which was well known to be studying bat coronaviruses. This logic struck me as a bit strained, but I trusted what the scientists were saying. And yet, more than a year later, I found myself immobilized in bed trying to reassure myself of this prevailing “natural” COVID-19 origin story.

Faulkner and the Word “Natural” in Medical Science

I had been reading William Faulkner at night when the virus struck. Specifically, Faulkner’s novel Flags in the Dust, where rural Mississippians are challenged by engineering and scientific advances in the wake of the first world war — specifically, the down-home matters of fast cars and medical advances.

Faulkner exemplifies the clash between the old and new world when the elderly Bayard Sartoris develops a spot on his face. Old Bayard is examined by two of the town’s doctors, a new-comer, and an old doc. The new doctor insists on immediate surgical excision, for science says the lesion will progress to cancer. The other doctor, who has long cared for the patient, calls surgery nonsense, for Bayard is so frail, he doesn’t have long to live. Besides, the old doc has seen Bayard whizzing around in a high-powered automobile, which is bound to get him killed. This accidental, unnatural death appears far more likely than any natural death from cancer. A relative agrees with the old doc. “Did you ever hear of a Sartoris dying from a natural cause, like anybody else?” Back and forth the doctors go as Bayard Sartoris listens, one doctor championing science, the other doing his best to practice medicine focused on an understanding of his patient.

Little surprise, in the end the only “natural” progression is a wrecked car and dead passenger. Such is the Faulkner fable of science and the word “natural,” a word which can keep questions racing in your mind when you’re hoping the COVID-19 fatigue will soon leave your body.

NIH Reports the Likely “Natural” Origin of COVID-19

As my COVID-19 fatigue waned, I searched the internet for updated information on the origin of the virus. I first turned to the go-to place for biomedical science, for I felt sure the March 2020 NIH COVID-19 origin statement would have been updated. To my surprise, it wasn’t. The hit was still there, and prominent. In the blog post, NIH Director Francis Collins, MD, PhD, describes scientific evidence suggesting the COVID-19 virus arose “naturally.” No weaponization, no devious bioengineering. The key word is “natural.”

Rereading the post, once again I sensed the scientists were implying the virus simply arose in nature, much as many bad things arise in nature. Sad to admit, but the process was normal. As Collins reported, “this study leaves little room to refute a natural origin for COVID-19.”

Moving beyond the NIH, I promptly found a far more recent story told by another leading scientist. On April 1, 2021, with approximately half a million Americans dead from COVID-19, a director at the Wuhan Institute of Virology published a COVID-19 origin story in the inaugural edition of a new scientific journal. The publication, which is sponsored by the Chinese Medical Association, was displayed on the NIH PubMed Central repository. In the origin story from Professor Shi Zhengli, PhD, any suspicion that the COVID-19 pandemic arose from a misadventure in her laboratory is bogus, for, “The scientific community strongly dismisses these unproven and misleading speculations and generally accepts that the SARS-CoV-2 has a natural origin…”

Once again, the word “natural” resonates. The professor also reports the World Health Organization (WHO) “fully clarified” that her institute had no role in the origin of the pandemic. This last comment struck me as profoundly misleading, since many reports describe Chinese officials refusing to fully cooperate with the WHO investigation. In fact, at the release of the preliminary report, the WHO Director-General himself cited major limitations in the investigation. Still, Zhengli had closed her COVID-19 origin story with a plea for global scientists to unite and work together “on the basis of science.” To Zhengli, it seems the sanctity and nobility of “science” transcends any questions about the scientific process.

NIH Needs to Update Their COVID-19 Origin Story

The fervor within the search for a reliable COVID-19 origin story was on display during a May 11, 2021 senate hearing where Sen. Rand Paul (R-Ky.) viciously questioned NIAID Director Anthony Fauci, MD, about NIH funding of research at the Wuhan Institute of Virology. Fauci adamantly denied any NIH-funding of gain-of-function viral research at the Wuhan institute, although in a chilling comment he also stated, “I do not have any accounting of what the Chinese may have done.” The chill in the comment reverberated when in an interview the next day, Fauci did mention indirect collaboration between the NIH and the Wuhan institute, perhaps including research whose integrity is now veiled by Chinese authorities. In follow-up, on May 19, 2021, the NIH issued a brief statement saying, “NIH strongly supports the need for further investigation by the World Health Organization (WHO) into the origins of the SARS-CoV-2 coronavirus.”

All in all, accumulating piece-meal information suggests NIH scientific leaders have doubts about the “natural” origin of COVID-19. Now, some NIH leaders and White House officials are calling for further investigation. Perhaps the NIH Director or other federal biomedical leaders are on the verge of updating the “natural” story of how the pandemic began. Otherwise, we should anticipate more conspiracy theories and worrisome speculations, more divisiveness and political rancor. What might help mitigate these problems, as well as enhance public confidence in science, would be an updated NIH story on the origin of COVID-19 — what’s known and unknown, and how the WHO and others are working to thoroughly investigate.

In Faulkner’s Flags in the Dust, engineering advances resulted in death and great suffering for a small-town family. The tradition-bound old ways simply wouldn’t work when calamities on the other side of the world produced havoc in rural Mississippi. Despite the tragic tale, Faulkner closed his novel with an optimistic image, a scene in which a visitor returns for a funeral. The visitor is a big-boned and roughly molded doctor, his eyes steady “and in all his ugly face there was reliability and gentleness and humor.” Faulkner’s syntax rarely seems arbitrary, so I have little doubt that “reliability” was the priority in the mind of the great storyteller. As Faulkner reminds us, our future depends on the reliability of doctors willing to tell true stories. After all, as I suspect all NIH scientists would agree, the priority in biomedical research is protection of the patient, not the science.

Dwaine Rieves, MD, is a graduate of the University of Mississippi School of Medicine. Following training in pulmonary and critical care medicine, he worked for 30 years as a physician scientist in the VA, NIH, and FDA. He currently advises academic institutions and pharmaceutical companies.