Opinion: COVID-19 lab leak origin makes more and more sense

• Dr. Greg Ganske is a retired surgeon and represented Iowa in Congress from 1995 to 2002.

A YouTube segment of the Stephen Colbert’s “Late Show” featuring Jon Stewart has gone viral. Stewart, the comedian appearing as a guest in June 2021, riffs about the origin of COVID-19: “The Wuhan Novel Respiratory Coronavirus Lab … the disease is the same name as the lab! That’s just a little too weird!” Colbert shifts uncomfortably in his seat as a wide-eyed Stewart becomes more and more animated that the “lab leak” hypothesis is correct, echoing sentiments of President Donald Trump and challenging the party line explanation that COVID-19’s origin was a natural occurrence.

Using humorous metaphor to make his point, Stewart goes on, “There’s been an outbreak of ‘chocolate goodness’ near Hershey, Pennsylvania, what do you think happened?” He sarcastically answers his own question, “I don’t know, maybe a steam shovel made it with a cocoa bean? Or is it the (expletive) chocolate factory!” Stewart then mocked the orthodox theory, “A pangolin kissed a turtle or a bat flew up the cloaca of a turkey and got into my chili?”

Whether he realized it or not, Stewart was echoing a medical diagnostic point my chief of surgery made long ago in teaching medical students. The students would try to stump him with an unusual medical case. And he would dissect the history, physical exam finding, and labs to come up with a diagnosis. He frequently made the point, “When you hear hoof beats, think horses, not zebras.” In other words, common diseases occur commonly and rare diseases occur rarely. So which is more likely?

This wise phrase was not original with my chief of surgery. The saying is attributed to Dr. Theodore Woodward, a respected teacher at the University of Maryland and charter member of the Infectious Disease Society of America whose work advanced the care of many infectious diseases. The saying is well known to most physicians of my generation. It is appropriate to remember this aphorism in discussing the origin of the COVID.

A few weeks ago the inspector general of the U.S. Department of Health and Human Services issued a report on the research that took place in China just before the first cases of SARS-CoV-2 in late 2019. In April 2021 I wrote an op-ed in the Des Moines Register on “Why we need to know the origin of COVID-19.” The IG’s report confirms my point that National Institutes of Health-funded research that EcoHealth Alliance was performing at the Wuhan Institute of Virology should have been more vigorously scrutinized.

The inspector general, Christi Grimm, found that “the NIH did not effectively monitor or take timely action to address EcoHealth’s compliance with some requirements to report research being conducted in Wuhan with U.S. funds.” Many virologists agree with biologist Alex Washbourne who told Yahoo News that the project at the Wuhan institute was “clearly gain-of-function research.”

Grimm found that the NIH had even “raised some concerns” about the research but did not end it. This, despite the fact that the U.S. government had warned about the safety of the lab’s virus protocols and precautions against a leak. The U.S. intelligence community also had evidence that several researchers at the Wuhan institute were sick with COVID-like symptoms in autumn 2019.

Why should a lab leak not be the leading contender? Safety breaches have happened even at state of the art biologic labs in the United States. In 2014, forgotten smallpox specimens in a cardboard box were unsafely transported to another building two blocks away. One of the vials was broken. Luckily it was only a tissue specimen and not one of the vials containing the virus, and nobody got sick.

The Chinese lab leak theory, however, was dismissed as a conspiracy theory. Anyone who even suggested it was called “xenophobic.” Even comedian Stewart was criticized for this talk show appearance that called attention to a probable lab leak. To counter this theory, Dr. Anthony Fauci and Dr. Francis Collins urged a group of virologists receiving NIH research grants, led by Peter Daszak, the head of EcoHealth, to publish a letter in the Lancet medical journal saying that the virus did not come from the Chinese lab but had a natural origin from an animal vector. The Lancet has since published a warning about the letter writers’ and Daszak’s conflict of interest in defending China. In the meantime, no evidence of a natural source of the virus has been found despite exhaustive search. Mr. Stewart’s “pangolin” doesn’t yet exist. China has hidden the data, blood samples that could be helpful in solving the origin, and denied access to Wuhan Institute of Virology lab and its workers. Only recently has Fauci admitted that a lab leak origin theory is valid.

The world simply does not know the facts needed to nail down this pathogen’s origin. However, we do know that the Wuhan lab was working on bat coronaviruses, that gain-of-function work was being done there, that there were concerns about the lab’s safety practices, that the pandemic started in the city where the lab is located, and that there has been no natural occurrence explanation of the virus. Which theory is most likely?

Maybe Colbert is unaware of “When you hear hoof beats look for horses, not zebras.” However, he surely has heard of Sutton’s Law. Willie Sutton was asked why he robbed banks. He replied, “Because that is where the money is.”

Dr. Greg Ganske is a retired surgeon and represented Iowa in Congress from 1995 to 2002. He served on the committee with jurisdiction over the National Institutes of Health.