This interview by Bruce Goldman was originally published by the Stanford School of Medicine.

On May 13, the journal Science published a letter, signed by 18 scientists, stating that it was still unclear whether the virus that causes COVID-19 emerged naturally or was the result of a laboratory accident, but that neither cause could be ruled out. David Relman, MD, the Thomas C. and Joan M. Merigan Professor and professor of microbiology and immunology, spearheaded the effort.

Relman is no stranger to complicated microbial threat scenarios and illness of unclear origin. He has advised the U.S. government on emerging infectious diseases and potential biological threats. He served as vice chair of a National Academy of Sciences committee reviewing the FBI investigation of letters containing anthrax that were sent in 2001. Recently, he chaired another academy committee that assessed a cluster of poorly explained illnesses in U.S. embassy employees. He is a past president of the Infectious Diseases Society of America.

Stanford Medicine science writer Bruce Goldman asked Relman to explain what remains unknown about the coronavirus’s emergence, what we may learn and what’s at stake.

1. How might SARS-CoV-2, which causes COVID-19, have first infected humans?

Relman: We know very little about its origins. The virus’s closest known relatives were discovered in bats in Yunnan Province, China, yet the first known cases of COVID-19 were detected in Wuhan, about 1,000 miles away.

There are two general scenarios by which this virus could have made the jump to humans. First, the jump, or “spillover,” might have happened directly from an animal to a human, by means of an encounter that took place within, say, a bat-inhabited cave or mine, or closer to human dwellings — say, at an animal market. Or it could have happened indirectly, through a human encounter with some other animal to which the primary host, presumably a bat, had transmitted the virus.

Bats and other potential SARS-CoV-2 hosts are known to be shipped across China, including to Wuhan. But if there were any infected animals near or in Wuhan, they haven’t been publicly identified.

Maybe someone became infected after contact with an infected animal in or near Yunnan, and moved on to Wuhan. But then, because of the high transmissibility of this virus, you’d have expected to see other infected people at or near the site of this initial encounter, whether through similar animal exposure or because of transmission from this person.

2. What’s the other scenario?

Relman: SARS-CoV-2 could have spent some time in a laboratory before encountering humans. We know that some of the largest collections of bat coronaviruses in the world — and a vigorous research program involving the creation of “chimeric” bat coronaviruses by integrating unfamiliar coronavirus genomic sequences into other, known coronaviruses — are located in downtown Wuhan. And we know that laboratory accidents happen everywhere there are laboratories.

All scientists need to acknowledge a simple fact: Humans are fallible, and laboratory accidents happen — far more often than we care to admit. Several years ago, an investigative reporter uncovered evidence of hundreds of lab accidents across the United States involving dangerous, disease-causing microbes in academic institutions and government centers of excellence alike — including the Centers for Disease Control and Prevention and the National Institutes of Health.

SARS-CoV-2 might have been lurking in a sample collected from a bat or other infected animal, brought to a laboratory, perhaps stored in a freezer, then propagated in the laboratory as part of an effort to resurrect and study bat-associated viruses. The materials might have been discarded as a failed experiment. Or SARS-CoV-2 could have been created through commonly used laboratory techniques to study novel viruses, starting with closely related coronaviruses that have not yet been revealed to the public. Either way, SARS-CoV-2 could have easily infected an unsuspecting lab worker and then caused a mild or asymptomatic infection that was carried out of the laboratory.

3. Why is it important to understand SARS-CoV-2’s origins?

Relman: Some argue that we would be best served by focusing on countering the dire impacts of the pandemic and not diverting resources to ascertaining its origins. I agree that addressing the pandemic’s calamitous effects deserves high priority. But it’s possible and important for us to pursue both. Greater clarity about the origins will help guide efforts to prevent a next pandemic. Such prevention efforts would look very different depending on which of these scenarios proves to be the most likely.

Evidence favoring a natural spillover should prompt a wide variety of measures to minimize human contact with high-risk animal hosts. Evidence favoring a laboratory spillover should prompt intensified review and oversight of high-risk laboratory work and should strengthen efforts to improve laboratory safety. Both kinds of risk-mitigation efforts will be resource intensive, so it’s worth knowing which scenario is most likely.

4. What attempts at investigating SARS-CoV-2’s origin have been made so far, with what outcomes?

Relman: There’s a glaring paucity of data. The SARS-CoV-2 genome sequence, and those of a handful of not-so-closely-related bat coronaviruses, have been analyzed ad nauseam. But the near ancestors of SARS-CoV-2 remain missing in action. Absent that knowledge, it’s impossible to discern the origins of this virus from its genome sequence alone. SARS-CoV-2 hasn’t been reliably detected anywhere prior to the first reported cases of disease in humans in Wuhan at the end of 2019. The whole enterprise has been made even more difficult by the Chinese national authorities’ efforts to control and limit the release of public health records and data pertaining to laboratory research on coronaviruses.

In mid-2020, the World Health Organization organized an investigation into the origins of COVID-19, resulting in a fact-finding trip to Wuhan in January 2021. But the terms of reference laying out the purposes and structure of the visit made no mention of a possible laboratory-based scenario. Each investigating team member had to be individually approved by the Chinese government. And much of the data the investigators got to see was selected prior to the visit and aggregated and presented to the team by their hosts.

The recently released final report from the WHO concluded — despite the absence of dispositive evidence for either scenario — that a natural origin was “likely to very likely” and a laboratory accident “extremely unlikely.” The report dedicated only 4 of its 313 pages to the possibility of a laboratory scenario, much of it under a header entitled “conspiracy theories.” Multiple statements by one of the investigators lambasted any discussion of a laboratory origin as the work of dark conspiracy theorists. (Notably, that investigator — the only American selected to be on the team — has a pronounced conflict of interest.)

Given all this, it’s tough to give this WHO report much credibility. Its lack of objectivity and its failure to follow basic principles of scientific investigation are troubling. Fortunately, WHO’s director-general recognizes some of the shortcomings of the WHO effort and has called for a more robust investigation, as have the governments of the United States, 13 other countries and the European Union.

5. What’s key to an effective investigation of the virus’s origins?

Relman: A credible investigation should address all plausible scenarios in a deliberate manner, involve a wide variety of expertise and disciplines and follow the evidence. In order to critically evaluate other scientists’ conclusions, we must demand their original primary data and the exact methods they used — regardless of how we feel about the topic or about those whose conclusions we seek to assess. Prior assumptions or beliefs, in the absence of supporting evidence, must be set aside.

Investigators should not have any significant conflicts of interest in the outcome of the investigation, such as standing to gain or lose anything of value should the evidence point to any particular scenario.

There are myriad possible sources of valuable data and information, some of them still preserved and protected, that could make greater clarity about the origins feasible. For all of these forms of data and information, one needs proof of place and time of origin, and proof of provenance.

To understand the place and time of the first human cases, we need original records from clinical care facilities and public health institutions as well as archived clinical laboratory data and leftover clinical samples on which new analyses can be performed. One might expect to find samples of wildlife, records of animal die-offs and supply-chain documents.

Efforts to explore possible laboratory origins will require that all laboratories known to be working on coronaviruses, or collecting relevant animal or clinical samples, provide original records of experimental work, internal communications, all forms of data — especially all genetic-sequence data — and all viruses, both natural and recombinant. One might expect to find archived sequence databases and laboratory records.

Needless to say, the politicized nature of the origins issue will make a proper investigation very difficult to pull off. But this doesn’t mean that we shouldn’t try our best. Scientists are inquisitive, capable, clever, determined when motivated, and inclined to share their insights and findings. This should not be a finger-pointing exercise, nor an indictment of one country or an abdication of the important mission to discover biological threats in nature before they cause harm. Scientists are also committed to the pursuit of truth and knowledge. If we have the will, we can and will learn much more about where and how this pandemic arose.  

A Long History of Hate

Like many racialized groups, Asians often face a variety of overt and covert attacks. As identified in the 2021 Stop AAPI Hate National report, overt violence and harassment of Asians includes acts such as yelling, bullying, physical attacks, and the use of racial slurs. Physical assaults increased from 10.2% of the total hate incidents reported in 2020 to 16.7% in 2021, while online hate incidents increased from 5.6% in 2020 to 10.2% in 2021.

For Min Zhou, these numbers are the most current evidence of a reoccurring cycle of violence and antagonism against Asians that reaches back to the earliest history of Asian communities in the United States.

“Historically, Asians have been considered an existential danger to the Western world and to American culture,” she explains. “They have been seen as a threat to the American working class and their struggle for labor dignity and rights.”

The first large migration of Asians into America was in the mid-1800s when workers from China joined laborers in the western United States in the booming mining and railroad building sectors. Initially praised as “useful workers” for their work ethic and willingness to endure backbreaking hours, Asian immigrants were quickly scapegoated as sources of vice and division when work became scarcer in the post-boom, contracting economy. Labor movements successfully codified discrimination against Asians in the 1875 Page Laws and 1882 federal Chinese Exclusion Act, and continued codifying systemic discriminatory practices in the Immigration Act of 1917.

Zhou explains that this kind of targeted discrimination against Asians resurfaces whenever Western society has felt cultural or economic competition with Eastern countries, citing the internment of Japanese Americans between 1942 and 1945 and the increase of violence against Asians following rising economic competition between East Asian and American auto manufacturers in the late 1980s and early 1990s.

“Anti-Asian racism today is nothing new,” cautions Zhou. “It is part of a longstanding history of systemic racism in the U.S.”

Understanding the Current Moment

But history is only one context for understanding violence against Asians. As Gabrielle Hecht, the chair of the REDI Task Force reiterates, “[There is] a tremendous variety of racists tropes, practices, and violence that run through American society that need to be addressed specifically as well as systemically.”

In the case of Asian discrimination, this includes dismantling the perceptions of the Asian American community as either a “model minority” or conversely as “perpetual foreigners.” As Eujin Park explains, both of these characterizations circumscribe Asian experiences into a framework of white supremacy and institutional violence.

Being seen as perpetual foreigners creates a narrative in which it is impossible for Asians to be authentically American or fully assimilate. The perception of being a model minority both upholds the myth that the U.S. is a race-neutral meritocracy and often fuels the perception that violence against Asians is limited to discrete personal experiences rather than part of a pattern of systemic and intersectional problems.

Examining how racialization intersects with sexualization, classism, ageism, and the broader Black-white paradigm of American race relations is crucial to understanding the very different experiences and varying types of discrimination within the Asian American experience. As a group, Asians are incredibly diverse, representing over 30 distinct countries of origin and innumerable cultural and ethnic groups. Over 60 and sometimes upwards of 70 percent of Asian communities in the U.S. are immigrants.

Looking to the Future

These overlapping and complicated realities of demographics, experience, and history mean that truly impactful advocacy against anti-Asian American violence will require equally interconnected and thoughtful partnerships and proactivity.

“This current moment is a significant opportunity for Asian Americans and our allies to expand our understanding of the violence that shapes Asian American lives and to turn our attention toward state and institutional violence,” says Eujin Park.

As for the particular responsibilities the Stanford community has in countering rising anti-Asian hate and violence, APARC Director Gi-Wook Shin, the moderator for the discussion counsels:

“It is not easy to participate in rational and constructive conversations, particularly those that are politically sensitive and involve many emotional components. Still, it is our duty as an academic community to confront these uncomfortable realities and engage ourselves in dialogue and discussions.”

This op-ed by Kiyoteru Tsutsui originally appeared in Nikkei Asia.

In one of the few unscripted moments in the meticulously planned U.S.-Japan summit meeting last Friday, President Joe Biden referred to Prime Minister Yoshihide Suga as "vice president" before quickly correcting himself.

In a different era, this could have turned into a diplomatic incident, with right-leaning Japanese pundits calling it evidence of the U.S.'s patronizing approach to Japan. Fortunately for Biden, the current geopolitical environment is not conducive to such provocation, and no major media picked up on the slip.

[Subscribe to APARC's newsletters to receive updates on our scholars.]

Much has been made of Suga being the first foreign leader to meet Biden in person. According to the U.S. State Department Office of the Historian, this is only the second time ever that a Japanese prime minister became the first foreign leader to meet a new president in the White House.

The other time was in 1989, when Prime Minister Noboru Takeshita visited President George H.W. Bush. Back then, Japan was a major threat to U.S. economic hegemony. Today, China is that threat, and not just in the economic domain. China is the first bona fide competitor to the U.S. since the Soviet Union, and its threat extends to every nook and cranny of the globe.

To counter China's ascension, the U.S. needs its allies, and Japan is the most important partner for that purpose. This is the context in which Suga visited the White House despite all the COVID-related restrictions.

Not surprisingly, the statements were carefully crafted to send strong signals to China. Building on the two-plus-two dialogue in March, the joint statement touched on the importance of peace and stability in the Asia-Pacific, from the East and South China seas to even Hong Kong, Xinjiang and Taiwan.

Japan certainly wanted a reference to the Senkaku Islands, which Beijing claims and calls the Diaoyu, and the applicability there of Article V of the U.S.-Japan Treaty of Mutual Cooperation and Security. The Biden administration had made that commitment earlier, calming concerns among Japanese leaders that the new administration may be softer on China than the Trump administration.

Biden has, in fact, been quite tough on China and has given almost a perfect answer to what Japanese foreign policymakers wanted. In return, the U.S. wanted Japan to be squarely on Washington's side. The wording of the joint statement — negotiated until the last minute — saw Japan agree to include a reference to Taiwan for the first time in 52 years, but with Japan's preferred wording, encouraging "the peaceful resolution of the cross-Strait issues."

Predictably, China reacted quickly and strongly, accusing the two countries of interfering in its domestic affairs and warning Japan about siding with the U.S. We have yet to see what retaliatory actions China might take, but the reference to Taiwan signals the beginning of a new trilateral relationship between China, Japan and the U.S.

The summit covered other important issues, all with China in the background. One key issue is economic security. In particular, supply chain decoupling will become a battle cry for the U.S. and its allies as they seek to reduce dependence on materials from China. Semiconductors are especially critical, as they power all the major growth areas in the new economy. Taiwan's dominance in the semiconductor industry is the main reason why Taiwan is so important to both sides.

To remain in the driver's seat in the new economy, the joint statement announced a new U.S.-Japan Competitiveness and Resilience (CoRe) Partnership. The most concrete proposal was an initial commitment of $4.5 billion from the two governments toward fifth generation (5G) and 6G networks, reflecting concerns about China's dominance in the key digital infrastructure of the future.

Human rights is another thorny issue, with the joint statement specifying concerns over Xinjiang and Hong Kong. With some companies joining the boycott campaign on cotton from Xinjiang, and China countering by criticizing racial division in the U.S., the clash between China and the U.S. will intensify in this area as well. Japan has stepped out of its comfort zone and criticized China on human rights, following the American approach more explicitly than before. In this regard, it is notable that Suga also referred to rising violence against Asians in the U.S.

One area in which China might be more of a partner than a competitor is climate change, with all three countries committing to zero emissions by mid-21st century. Almost concurrently with the Biden-Suga meeting, American and Chinese climate envoys — John Kerry and Xie Zhenhua — met in China and issued a joint statement affirming their commitment to work together on global climate challenges.

All these initiatives and commitments are potentially meaningful and consequential developments that can reshape the Indo-Pacific, although more concrete ideas are needed before we can evaluate their impact. The biggest take-away ought to be the confirmation that the U.S.-Japan alliance is gearing up for a new era of competition with China.

Japan more than reaffirmed its commitment to the alliance with the U.S., risking its economic relations with China. The U.S. will be sure to ask for more concrete actions from Japan on the basis of the joint statement, and Japan can no longer evade questions about what it would do in a confrontation with China. Japan has to navigate a tough terrain of standing with the U.S. in the competition with China while preventing the escalation of tensions between Beijing and Washington, and at the same time protecting its own national interests.

A new phase of the trilateral relationship has just begun, and like it or not, other Asian nations might face the same decision that Japan faced, and sooner rather than later.