169 - COVID-19 Lab Leak: Examining all sides of the debate & the barriers to a full investigation

1. 0:00 – 0:10

   Intro

   1. PAPeter Attia0:00

      [upbeat music] Hey, everyone. Welcome to "The Drive" podcast. I'm your host, Peter Attia. [upbeat music]

2. 0:10 – 4:23

   An overview of the lab leak controversy;

   1. PAPeter Attia0:10

      Hey, Katherine. Great to, uh, great to have you back on the show here.

   2. KEKatherine Eban0:14

      Awesome to be with you again.

   3. PAPeter Attia0:16

      Uh, it seems we're always discussing something controversial, so, uh, uh... And by the way, I already know what our third podcast will be about based on other [laughs] controversial work you've done, so.

   4. KEKatherine Eban0:25

      [laughs]

   5. PAPeter Attia0:26

      Um, yeah, you don't like to write about things that are simple.

   6. KEKatherine Eban0:30

      No, I don't seem to. It is the fate of the investigative journalist.

   7. PAPeter Attia0:34

      [lip smacks] Um, well, let's start with a broad question, which is what attracted you in particular to this story and why did you decide that you had something to offer? Especially in a story where, um, not to let too much out of the bag too soon, but it seems that this is not something that can truly ever be known one way or the other. Uh, so it, it seems a, a bit of a, a frustrating exercise.

   8. KEKatherine Eban0:59

      Yeah. Well, I'd been covering the pandemic for a year for Vanity Fair and, you know, as things have come a little bit more under control in the US, at least for the time being, uh, my editor and I were like, "What are the big unanswered questions of the pandemic?" And we decided that the biggest, uh, is what its origin was. Um, now, you know, one might say, "Well, that was settled a while ago," or seemingly settled, right? It came from nature, but we don't know exactly how or where. Um, but it was interesting because the head of the World Health Organization himself said, "We still don't know," you know, and all hypotheses remain on the table. So it seemed that with Trump out of office, with the WHO head himself raising this as a question, uh, it was a good time to begin to look into what was the sort of... What's the debate? What's the controversy? What are the questions? Uh, and what I uncovered was a lot more than I had really considered or bargained for when I started my reporting.

   9. PAPeter Attia2:17

      [lip smacks] Maybe for folks we should give a little bit of background on what a lab leak implies. Is there a precedent for such a thing in virology? Um, because at the surface it certainly sounds nefarious, right? It sounds like, well, that must be a deliberate thing, and it immediately-

   10. KEKatherine Eban2:37

       Mm-hmm

   11. PAPeter Attia2:37

       ... falls into the realm of conspiracy theories. Um, but in fact, there's quite a precedent for viruses getting out of labs in the modern era, and I would define the modern era as the era of microbiology. Obviously, there weren't lab leaks that accounted for the Spanish flu. Um, but are there any that, that come to mind as you began your work, uh, here or that you had to learn about as a, as a result of your investigation?

   12. KEKatherine Eban3:04

       Yeah. So let me say first that lab leak, um, as it's understood, is not a unitary theory. Uh, it ranges all the way from, uh, you know, field researchers went into a bat cave, brought back natural samples into a laboratory, and that natural sample somehow leaked. Or a laboratory researcher got infected simply through, you know, aerosol transmission, which is what we're talking about. This is not... I mean, the word leak implies, like, liquid gushing out of a pipe. That's not what we're talking about. We're talking about aerosol transmission. But it could've been an infected lab worker. It could've been an infected field researcher bringing a sample back. But the, you know, phrase lab leak sort of runs all the way up to the possibility that someone in a laboratory was manipulating viruses, potentially, uh, in an experiment to make them more infectious to see if they would become more infectious, and that that new strain, not a natural strain per se, but one that was genetically modified, could have leaked from a laboratory.

3. 4:23 – 7:43

   The troubling history of lab leaks of dangerous pathogens;

   1. KEKatherine Eban4:23

      So it really runs the gamut. It's not a single thing. And y- y- yes, you know, lab leak, um, i- this is not like, "Oh, how could that ever happen?" In a way, it's like, how could it not happen? Because it's happened over and over and over again. You know, you had very serious lab leak in the Soviet Union, which finally became exposed. It was an anthrax leak. You've had SARS leaks. You've had four SARS lab escapes since the SARS epidemic of 2002. Um, so this actually is something that happens a lot.

   2. PAPeter Attia5:04

      A- and, and it seems that one of the, um, most significance, uh, examples of this was this Russian flu in 1977, which was, uh, an H1N1 flu that had been around in the '40s and '50s. Um, [lip smacks] it was being studied in a lab. It-- When it remer- When it reemerged, it seemed to target disproportionately people that were, you know, younger than 25, which at the time maybe didn't make sense, although after it was clear that this was the same virus that was around sooner, it made sense because obviously the people that were being afflicted were people that did not develop natural immunity. Um, again, there had been no, to my knowledge of course, because you wouldn't have had the tools to have done so, there was no gain of function. Not that they could've genetically edited, but I don't believe there was evidence that it had been sort of selectively bred or anything like that. It was simply a question of this is a virus that's being studied in a lab, and then somehow that led to it, um, getting, getting out. And as you point out, um, at least four cases of the-

   3. KEKatherine Eban6:02

      Yeah

   4. PAPeter Attia6:02

      ... early s- SARS1 virus, um, escaping Uh, and again, when you read the stories of these, which I've, I've read at one point all of them-

   5. KEKatherine Eban6:11

      Mm-hmm

   6. PAPeter Attia6:11

      ... it, it's, it's these are mistakes that people can make. It's, you know, these are perhaps viruses that are not being handled with as much care as they should be handled. Some shortcuts are being taken with respect to, um, how they could be handled.

   7. KEKatherine Eban6:25

      Y- you know, I think it's, it's important to point out that people talk about, you know, BSL-4 labs that are studying these incredibly dangerous pathogens. And so those are the, uh, most protective, uh, highest containment labs where all of the researchers are working in spacesuits with independent oxygen. But the fact of the matter on the ground is that you have, uh, research with incredibly dangerous pathogens taking place in laboratories across the world that have much less protection, like BSL-2 labs, which are basically the safety standard of an American dentist's office. Um, you know, so, so you've had live, live SARS viruses being studied in, uh, overcrowded laboratories, you know, in China and elsewhere, um, with very little protect- very few protections.

   8. PAPeter Attia7:29

      So there's at least a precedent that a virus that's being studied can make its way out of the lab. Uh, in fact, there's, there's a great precedent for it. Um-

   9. KEKatherine Eban7:39

      Mm

   10. PAPeter Attia7:39

       ... but of course, that alone doesn't explain what could have happened here.

4. 7:43 – 24:05

   The zoonotic transmission theory: did SARS2 come from a bat?;

   1. PAPeter Attia7:43

      It, it, it's probably worth also explaining for folks who haven't been so steeped in this story, or at least re- reminding people of the typical way in which a virus can be transmitted between animal hosts and what it means to have an intermediary host and how, for example, those were identified in the cases of SARS1 and MERS.

   2. KEKatherine Eban8:04

      Mm-hmm. Mm-hmm. So, um, you know, it was presumed early on that like other past viruses, SARS-CoV-2 had a zoonotic origin, meaning that it spread somehow from an animal and jumped to a human, or that there was an intermediary animal, so, uh, possibly a pangolin, possibly a civet cat, and that it went from a bat reservoir to some intermediary animal to humans. So that is believed to be the case with, um, SARS-CoV-1. That is believed to be the case with MERS, where there was a, a dromedary as an intermediate host, and with the initial animal being presumed to be some sort of bat reservoir. Uh, with Ebola, it's believed to have a zoonotic origin, either a bat or a chimp. Um, it's not certain yet. Um, but that is the, you know, that is the long history, um, of these viruses, that it has some kind of natural origin and then, um, evolves and mutates in such a way that it can infect a human.

   3. PAPeter Attia9:25

      And I think one of the questions here, in the, in the case of SARS1, it didn't take that long, I believe it was, you know, in the order of about six months, to identify-

   4. KEKatherine Eban9:34

      Right

   5. PAPeter Attia9:34

      ... its intermediary, which is, what's it called, like a civet? Like, it's sort of like a little... It's, it's a little-

   6. KEKatherine Eban9:40

      A civet cat. It's very cute.

   7. PAPeter Attia9:41

      Is it a civet cat? Yeah, yeah, yeah.

   8. KEKatherine Eban9:42

      It's a v- yes, a very cute animal.

   9. PAPeter Attia9:44

      Yeah. And obviously in MERS, as you mentioned, a, a camel. Um, what's relevant about this is that, um, that, that they can, that the virus can a- can acquire additional tools in that intermediary host before making that final leap. And then so the question is, how much of the transmission occurs between, say, the cat and the human, or once that transmission occurs, is most of the transmission occurring human to human? And so as of, as of now, which is, you know, directionally call it a year and nine months post the first infection-

   10. KEKatherine Eban10:23

       Mm-hmm

   11. PAPeter Attia10:23

       ... we don't yet have an identified intermediary host, which implies that it exists, but it hasn't yet been identified or there wasn't one, and this might have traveled directly from bats to humans.

   12. KEKatherine Eban10:34

       Okay.

   13. PAPeter Attia10:34

       For which there's clearly a precedent based on what happened in 2012, right?

   14. KEKatherine Eban10:39

       Well, l- let me just say that, um, we don't yet have a designated animal host, and it's not for lack of trying to find one. So, uh, the Chinese authorities have tested up to 80,000 animal samples to see if they could find a host animal, uh, and have not been able to do so. So there has been, uh, you know, you could think of it as an international bat hunt to find the host animal, um, of this virus, and none has presented itself yet.

   15. PAPeter Attia11:17

       Right. So we have, we haven't identified the potential bat source of it. We haven't identified the intermediary of it. Um, there is a close, closest relative that has been identified, correct?

   16. KEKatherine Eban11:33

       Yeah. So I, that is a sort of complicated question, but there is a strain, uh, RaTG13, which was found in an abandoned mine shaft in Yunnan Province, um, in 2013, which is sort of the closest, uh, viral sample to s- the SARS-CoV-2 sequence. So it's about, uh, 96.2% identical, uh, to, to SARS-CoV-2.

   17. PAPeter Attia12:11

       And what, what do we know about that, um, that, I don't wanna say accident, but that experience in 2013 where the miners were exposed to it? What do we know about their illness and, and what does that tell us about, uh, that virus?

   18. KEKatherine Eban12:28

       So there's a couple of really interesting things about, um, about what happened in 2012. First of all, that it happened, what happened, but also how it came, um, how it sort of broke into the public domain, what happened. Um, so just starting out, in 2012, there were six miners who were given this very unpleasant assignment, which was to go to this abandoned mine shaft and dig, uh, clean it out, 'cause it, it, it was thick with bat guano, which is bat feces essentially. So they go in there and they dig for, uh, days and weeks, and they become gravely ill. So they become admitted to the hospital, um, and the ho- uh, in, um, Kunming University Hospital. So they get admitted to the hospital. The question is, is it a fungus? Is it a virus? Um, they bring in, um, an expert, uh, who analyzed this, says it's a virus. Um, they have pneumonia. It's a virus. Their symptoms were almost identical to COVID-19. Um, uh, so he asked, "What were they doing?" They were digging up bat guano. What kind of bat? It's this Chinese rufous horseshoe bat, which is the same one that, um, that triggered SARS-CoV-1. Um, three of the miners die. Three ultimately recover. So, you know, this is a case that should have triggered worldwide alarm because it looked like the beginning of an outbreak again. But the Chinese authorities never reported this to the World Health Organization. It sort of remained below the radar, except that this abandoned mine shaft became a destination for, um, virologists in Asia who were going into this mine shaft and getting samples and bringing it back to their laboratories. Um, probably the most active samplers from this mine shaft were, um, were members of the Wuhan Institute of Virology, uh, in Wuhan. They dug up many samples, brought it back to their laboratories, and they sequenced a sample which they called at the time four nine nine one. And that was, as we would find out later, 96.2% identical to SARS-CoV-2, except at the beginning of the outbreak, nobody knew about this mine shaft. Nobody knew that three miners had died, and no one knew about four nine nine one. Um, the only way that we ultimately found out about it is because a very curious s- uh, unemployed science teacher, um, in Eastern India started digging into this database of Chinese master's theses and pulled up an entire dissertation about this incident in the mine shaft.

   19. PAPeter Attia15:46

       Now [clears throat] to be clear, it would not have been known based on the infection of those six mine shaft workers and the, with a, basically a 50% mortality, that there was any evidence that that virus could be transmitted human to human. Um, correct? It could have been simply that, um, you know, they acquired it from the bats, which is the most likely scenario i- in the presence of an overwhelming exposure to the virus, uh, but that the virus would not transmit human to human. Is-- Would that have been-

   20. KEKatherine Eban16:18

       That's right

   21. PAPeter Attia16:19

       ... possible?

   22. KEKatherine Eban16:20

       I mean, that, that's right. We, we, we have no information that, that they infected one another. They were all exposed to this bat guano. They went to the hospital. Doesn't appear that the hospital workers got sick, so you know, it's not, doesn't appear that they spread it to other people. But they were desperately ill, and it's interesting to note the oldest miner died first. He was the most gravely afflicted. He was in his sixties. Um, uh, you know, so if, if we look back at this incident in light of COVID-19, you know, there are a number of aspects of this that do look like SARS-CoV-2 in 2012.

   23. PAPeter Attia17:08

       Though clearly it's a different virus given that... I, I mean, I think for, for a person listening maybe not familiar with genetic distance-

   24. KEKatherine Eban17:17

       Mm-hmm

   25. PAPeter Attia17:17

       ... 96.2%-

   26. KEKatherine Eban17:19

       Right

   27. PAPeter Attia17:19

       ... sounds, um, like, oh, that's a perfect match. But of course, that's-

   28. KEKatherine Eban17:23

       Right

   29. PAPeter Attia17:23

       ... not remotely a match. Uh, you know, I've spoken with virologists who have said, "Look, to try to take a virus from 96.2%-

   30. KEKatherine Eban17:33

       Mm-hmm
5. 24:05 – 32:08

   The debate about gain-of-function (GoF) research;

   1. PAPeter Attia24:05

      Now, how long has the, uh, institute been doing gain-of-function research? And maybe even before we answer that question, we could take a moment to explain what gain-of-function is. It's actually not perfectly, um, uh... There, there isn't, there isn't an exceptional definition for it, but, but I think we can loosely describe it.

   2. KEKatherine Eban24:30

      Sure. So, you know, first of all, um, there are, there are, um, some people who say that all of virology is gain-of-function research, which is basically when you study a virus, you are seeing sort of what functions it gains and what functions it loses. You know, how does it infect? Um, is it going to become more infectious, and by what mechanism is it going to become more infectious? So gain-of-function research, put simply, is this idea that you are trying to, um, test whether the pathogen can become more infectious. You're trying to give it attributes that it doesn't possess in nature as a way to gauge its infectiousness to humans. Um, yeah, sorry. Go ahead.

   3. PAPeter Attia25:25

      No, no, I was just gonna say, look, at the surface, I think if you're listening to this and you don't dabble in this world, that sounds a bit absurd, right? We're gonna take a virus that may have a certain level of either virulence or lethality, um, or transmissibility, you know, some feature that makes a virus undesirable, and we're going to enhance that. So [clears throat] what's the argument for doing that? What's the argument for making a bad virus worse or making a good virus bad?

   4. KEKatherine Eban25:59

      So, you know, first of all, let me say, this is hugely controversial and has sort of divided the field of virology, um, because there are people who say, "This is absolutely crazy." You know, as one source said to me, "It's like... It's like looking for a gas leak with a lighted match." And there are other people who say, "This is absolutely essential." So the argument for why to do it is that, um, in order to gauge the risk, um, from viruses that exist in nature, you have to experiment with how they become infectious to humans, and one of the ways to do that is essentially to soup up that virus. You know, you can, um, through genetic, uh, editing, you can make it more infectious and see if it is, you know, one of these things that it's, it's a determination of where we should put our resources. You know, what do we need to protect against? Um, there are other people who say, "All right. We're going to these very remote areas where these viruses are tucked inside these caves. We're taking back samples to laboratories in crowded urban areas. We are then altering these pathogens to make them more infectious," right? That is, as one person said to me, the definition of insanity.

   5. PAPeter Attia27:32

      Is there any evidence that gain-of-function research has produced victories in the past? And we can even just keep, you know, SARS-CoV-2, um, o- off the, off the list at the moment 'cause I don't think there's any evidence it's benefited our fight against this virus. But is there any evidence it has aided with the creation of flu vaccines or other vaccines?

   6. KEKatherine Eban27:55

      Right. So, so the people who defend it say that you actually do need to do this kind of research in order to, um, help with vaccine development, that this is the way that you figure out how to create resistance, is to look at, to experiment with how viruses might mutate so that, for example, if you wanted to, you know, kind of forecast what the variants of SARS-CoV-2 would be, like, as I'm sure the audience has heard of, you know, the fearsome Delta variant, which is so afflicting many countries in the world and now increasingly our own, um, part of, you know, part of what gain-of-function research can help do is forecast the mutations. Um, uh, but I... You know, there are people who say that there is a lot of other ways to do this kind of research without running the risk of unleth- unleashing, um, you know, deadly pathogens that you can't control once they're out in the world.

   7. PAPeter Attia29:06

      Now, what's the US government's position been on gain-of-function research?

   8. KEKatherine Eban29:11

      Yeah, so this is... Uh, you know, when I started... Let me just say, as a journalist, um, and as an investigative journalist, I had been reporting on the pandemic for a year, and once I got into this question that you just asked, I was like, "Wow, I can't believe how controversial and yet how under the radar this whole question has been." So, um, just to back up, in 2011, a scientist named Ron Fouchier, um, did gain-of-function research with the H1N1 virus and, um, created, uh, a, a, um, a pathogen that he said was the most dangerous and infectious the world has ever known, uh, through manipulations. So that sparked this outcry in the scientific community. Um, a group called the Cambridge Working Group was formed, which was basically stood in opposition to this kind of research, and their expressions of concern led the US government to impose a moratorium on any kind of, uh, gain... funding of any kind of gain-of-function research of SARS and MERS pathogens. Um, so then began a period of review, task forces, reports, um, analysis, and interestingly, in the very beginning of the Trump administration in, in January of 2017, that moratorium was lifted. Um, but it was replaced with this framework which had pretty much enough, you know, loopholes to drive a truck through. But it basically said any agency in the US government that wants to fund this kind of research needs to have its own review process in place and needs to ensure that the entities that are getting US taxpayer dollars are proceeding safely.

   9. PAPeter Attia31:28

      I know that one of the, one of the things that has, has allowed people to sort of lose faith in the government has been statements that both Francis Collins and Anthony Fauci have made with respect to this when asked. Uh, both of them have been asked if the United States government or specifically NIH has funded, uh, gain-of-function research. Both have emphatically denied it. I, I believe, uh, the direct quote, uh, from Francis Collins, "Neither NIH nor NIAID have ever approved any grant that would have supported gain-of-function research on coronaviruses that would have increased their transmissibility or lethality for

6. 32:08 – 51:19

   Questions about US funding of GoF research in China;

   1. PAPeter Attia32:08

      humans." Um, also in May of 2021, Anthony Fauci told the Senate hearing that NIH and NIAID categorically have not funded gain-of-function research to be conducted at the Wuhan Institute of Virology. Can you evaluate the veracity of those statements?

   2. KEKatherine Eban32:29

      So here is where we enter this true semantic marshland, um, because the, the feeling of... And I'm not talking about sort of wingnuts who wanna fire Fauci. Credible people who have evaluated this say that there is some sort of rhetorical, uh, gray area here. Um, uh, first of all, while they haven't funded research, uh, while the government hasn't funded research at the Wuhan Institute of Virology directly, they have funded, uh, basically an intermediary nonprofit called EcoHealth Alliance, which in turn has given subgrants to the Wuhan Institute of Virology. So yeah, no direct funding, but yeah, indirect funding. Now, part of the obligation of EcoHealth Alliance was to report back to the NIH and say, you know, "Here's our progress reports. Here is, you know, what the Wuhan Institute of Virology was doing with some of your grant money, and we ensure that they've been doing this safely." We don't know what's in those progress reports because NIH has not released them. Um-

   3. PAPeter Attia33:51

      That, that smells like a FOIA waiting to happen.

   4. KEKatherine Eban33:55

      Oh, I'm... The NIH now is, like, being buried up to their eyeballs in FOIAs. Absolutely. You know, people wanna know what did they know about this research. Um, you know, there, there are numerous investigations ongoing into that very question right now, including from the HHS Inspector General. So there, there's a lot of questions around this and not, you know... And, and let me just say, um, part of the reporting effort for me was, um, disentangling conspiracy theories, and there's, you know, there are wall-to-wall conspiracy theories out there, um, you know, disentangling the ones that have no basis in reality and then trying to evaluate the credible questions, right? So in my investigation, there are credible questions, um, you know, about that funding. I mean, why were we giving taxpayer, why were we allowing taxpayer dollars to, you know, a high-level Chinese laboratory where we now believe there was actually military scientists working in there? They're obviously an adversary. As, as one person said to me, "Hey, what, what's wrong with the Louis Pasteur Institute, you know?" I mean, maybe we should make more of an effort to restrict our research dollars to, uh, the s- the science laboratories of, of allies and not adversaries.

   5. PAPeter Attia35:32

      W- Tell me a little bit about EcoHealth Alliance. Why are they acting as an intermediary? What's their mission? What does this organization exist to do?

   6. KEKatherine Eban35:41

      Um, so EcoHealth Alliance is a nonprofit which is run by a fellow, a zoologist named Peter Daszak, uh, and has a very laudable goal, which is basically to, um, uh, sort of map the viruses in the natural world and use that information in part to preserve wild spaces, right? If we continue on the path of habitat destruction and we end up sort of, you know, cheek by jowl close to these, uh, viruses like Ebola, it's, you know, i- we're both extinguishing the natural world and endangering our own, uh, health and safety on this planet. So that is the s- the goal of, uh, EcoHealth Alliance. But the organization was pushing very, very hard for big funding dollars, uh, not just to fund You know, this research on a small scale, but had their eyes on something called the Global Virome Project, which was basically a massive mapping of the world's viral strains. And [laughs] you know, as one of my sources said, "Then it's not just looking for a gas leak with a lighted match, it's looking for a gas leak with a blowtorch," right? If you're going into all of these wild spaces and you're pulling back, bringing back all of these dangerous, uh, viruses, you know, and potentially unleash- unleashing pathogens, you know, the scientific question here is, do we need to know all the answers to this? Or can we just kinda leave the caves to themselves and, you know, make sure that we closely regulate all of this activity? So fast-forward to the Trump administration. In the middle of the COVID outbreak, uh, Trump gets asked at a news conference, um, uh, by a journalist from a right-wing media outlet called Newsmax, um, "Why, why is the US government giving money to the Wuhan Institute of Virology?" Which was inaccurate, but Trump answered, "We know about that, and we're gonna shut it down." About a week later, um, the NIH is forced by the White House to sever or to stop the grant to EcoHealth Alliance. You know, so at that moment it looked very much like, wow, the Trump administration is really interfering with the science. This is critically important research in a time of COVID-19. But as the story has evolved, you know, there are real questions about what was going on in the Wuhan Institute of Virology, what, uh, our taxpayer dollars was funding there, um, and because of the lack of transparency, it's very hard to evaluate that.

   7. PAPeter Attia38:42

      So let's go back to sort of January 2020-

   8. KEKatherine Eban38:46

      Mm-hmm

   9. PAPeter Attia38:46

      ... when the virus was identified, sequenced. Uh, I, I think it still looked somewhat contained, uh, at least contained to China.

   10. KEKatherine Eban38:56

       Mm-hmm.

   11. PAPeter Attia38:56

       They had shut down Wuhan. You mentioned that in September, I believe, of 2019, the database-

   12. KEKatherine Eban39:04

       Mm-hmm

   13. PAPeter Attia39:05

       ... of all viruses extracted, uh, from the mine, presumably the database would have contained all viruses that they had been working on as well?

   14. KEKatherine Eban39:16

       Yes.

   15. PAPeter Attia39:16

       That had been taken down.

   16. KEKatherine Eban39:18

       That is right, and we don't know why, and it hasn't been put up since then. So, so s- you know, what was presumably this transparent, uh, hub of international science with Shi Zhengli doing these, uh, you know, research experiments and collaborating with scientists around the world, suddenly it was like the, the, you know, steel doors in front of this, this institute just sh- were sh- you know, shut, shut tight. And, and, um, nobody can see into what strains they had.

   17. PAPeter Attia39:58

       [lips smack] What... I mean, there was a Lancet paper that came out in February of 2020 that very aggressively made the case that any suggestion that this didn't originate in nature was ridiculous. Um, that... Was that a peer-reviewed paper? Was it an, was it an editorial? What, what was the nature of that paper? Was it an opinion piece?

   18. KEKatherine Eban40:26

       Yeah. So, you know, it's important to note it was not a peer-reviewed paper. It was a statement which was published by 27 scientists, um, who said basically anybody who is saying, um, that this could have had a lab origin is siding with c- is trafficking in conspiracy theories, and we stand with our fellow scientists in China, uh, to say that this had a natural origin. It was a big piece of branding, right? That suddenly raising the question of the lab leak, um, was aiding and abetting Donald Trump's xenophobic agenda, aiding and abetting conspiracy theorists. And as, um, you know, one of my sources said, "It was like it was nailed to the church door." It became the orthodoxy, and it really shut down debate. But there was something more consequential that emerged from that Lancet statement. The scientists who signed it asserted that they had no conflicts of interest. The problem was the, the person who had sort of designed and orchestrated the statement, uh, was Peter Daszak, who is the president of EcoHealth Alliance. A number of the scientists who also signed were either employees of him or had received grant money, um, and even though he's saying he, they, that he has no conflicts of interest, he was providing money to the Wuhan Institute of Virology. So it was not a kind of neutral value free assertion, right? Um, he has a stake in this. He definitely has a stake in this. Um, as, as somebody pointed out, you know, if it turns out to have been a lab leak, it, it could do to the field of virology what Chernobyl did to the world of nuclear science research, right? Transform the whole thing, shutdowns, restrictions, moratoriums. Um, so Peter Daszak as the recipient of million... Well, not personally, but EcoHealth Alliance as the recipient of millions of dollars in grant money, uh, definitely had, um, [lips smack] uh, you know, a horse in this race.

   19. PAPeter Attia42:47

       Besides, um, NIH, who else would be funding this type of research? Would the DoD be funding any of this research?

   20. KEKatherine Eban42:54

       It has. DoD gave grants to EcoHealth Alliance. Um, you know, and, and so as I spoke with investigators inside the US government who were looking at COVID origins over the last year, what they found is that there is a big, they called it gain-of-function bureaucracy inside the federal government. There are a lot of people who are invested in this kind of research, who are giving grant money for this kind of research. Um, so they, you know, they have committed to this kind of very aggressive viral research. Um, and so they have, um, you know, an interest in the outcome of this question. And as these investigators told me, it had an enormous impact on their ability to just neutrally evaluate the question of origin.

   21. PAPeter Attia43:57

       This is more of a question of speculation, but do you think that had all of this taken place in a world where it had not been politicized, in other words, if politicians, including the president of the United States, had never weighed in on this, if this were a discussion that were only going to take place in the scientific community, do you think the reaction would have been as polarizing?

   22. KEKatherine Eban44:20

       It would have made a huge difference. I mean, partly this became so polarized because President Trump, at that point lacking a lot of evidence, in April 2020 announced it was a lab leak, um, that he was certain it was a lab leak. You know, and-

   23. PAPeter Attia44:42

       Is there any evidence that he had intelligence to suggest that, or was this simply an off-the-cuff statement?

   24. KEKatherine Eban44:51

       Right. So according to my sources, the most significant information that the US government obtained came in the fall of 2020, you know, late summer or fall of 2020. So April, um, of 2020 really predates a lot of the significant information that the government collected. Couple that with the fact that on the, on the same day that he declared he was certain it was a lab leak, hours earlier his own intelligence agencies put out a statement saying, um, "We are certain that this was not genetically modified." As it turns out, they didn't particularly have evidence for that either but, uh, you know, it's clear that elements of the US government were sort of ping-ponging off of these xenophobic declarations that President Trump was making, you know, not necessarily as a good faith effort to get to the bottom of it, but more as a way to bludgeon China. You know, and, and, and as you know, he, he labeled the COVID-19 Kung Flu. Uh, he made a lot of very sort of negative assertions, um, and, and it had this tremendous effect. It, it created, as one source told me, an antibody response within the federal government, uh, to the idea that it was a lab leak.

   25. PAPeter Attia46:29

       Was there censoring, um, for these ideas or questions on social media? I wasn't particularly paying attention in the spring of 2020 to this, but, um, w- was this the type of thing that if you had posted something about this on Facebook, was it gonna be taken down? I mean, what was the, what was the level of, um, curiosity around this and, and how much was, was, was being explored?

   26. KEKatherine Eban46:56

       Well, it's interesting because, you know, some, some social media sites, I believe including Facebook, were labeling posts like this as conspiracy theories. Uh, and there has been some reversal since then, you know, also in the media where you have now, um, sites like Vox that were, you know, posting disclaimers about conspiracy theories are now lifting those statements as the idea of a lab leak has gained in some credibility.

   27. PAPeter Attia47:28

       So let's, um, let's march through the government a little bit more here in terms of, um, the, the efforts that were made to sort of try to get to the bottom of this, because really everything we're talking about is, is not really front and center, right? I mean, front and center is containing this virus-

   28. KEKatherine Eban47:48

       Right

   29. PAPeter Attia47:48

       ... vaccine development.

   30. KEKatherine Eban47:49

       Right.
7. 51:19 – 59:35

   The uncertain significance of the furin cleavage site;

   1. PAPeter Attia51:19

      So let's talk about some of the lines of evidence both for and against this. I mean, I think what's, what's clear here-

   2. KEKatherine Eban51:27

      Mm-hmm

   3. PAPeter Attia51:28

      ... is, one, there's a precedent for this happening, right?

   4. KEKatherine Eban51:30

      Mm-hmm.

   5. PAPeter Attia51:30

      So it's, it's, it's, it's an absolutely plausible scenario. Um, two, unfortunately, because of the nature of the Chinese government's behavior and by extension [chuckles] the US government's behavior-

   6. KEKatherine Eban51:46

      Yeah

   7. PAPeter Attia51:46

      ... there's ample-

   8. KEKatherine Eban51:47

      Yeah

   9. PAPeter Attia51:47

      ... reason to believe in a conspiracy, but by no means is that necessary. In other words-

   10. KEKatherine Eban51:54

       Right

   11. PAPeter Attia51:54

       ... this virus could have completely occurred in nature, and the Chinese government would probably still behave the exact way it did, and the US government-

   12. KEKatherine Eban52:03

       Mm-hmm

   13. PAPeter Attia52:03

       ... would have behaved exactly the same way it did.

   14. KEKatherine Eban52:06

       Right.

   15. PAPeter Attia52:06

       So, you know, unfortunately, those things don't really, I think, move the thinking or the evidence one way or the other more than the other. Um, but now let's talk about some of the features of the virus, 'cause I think this is where, um, it gets very... I mean, not that, not that, not that what we've said hasn't gotten interesting, but, but the biology of this is also quite interesting, right?

   16. KEKatherine Eban52:29

       Mm-hmm. Yeah. So, um, you know, there has been a lot of... Let me first say that I don't think there, there is no information that is in the public domain either regarding, uh, the viral sequence and the sort of oddities of the viral sequence, um, you know, or regarding other circumstantial evidence that can answer this question one way or another. You know, you... When I started reporting this, there was, you know, there were plenty of articles that were like, "Well, maybe this and maybe that," you know? But the information that is in the public domain doesn't get you there. Um, some attention, or a lot of attention, has been focused on what is called a furin cleavage site in the sequence. Um, and that is, you know, part of the strain that one virologist told me is a sort of signature of genetic editing of the Wuhan Institute of Virology, that in a number of the strains they've worked on and manipulated and published papers about, you see the insertion of a furin cleavage site in the, uh, in the viral sequence. Um, and that is the spot on the sequence that makes it more infectious to humans. So Nick Wade, who's a former New York Times, uh, reporter, you know, he published a long piece sort of analyzing the question of the science and the lab leak, and he quoted, you know, this incredibly famous scientist, David Baltimore, saying, as soon as he heard about the furin cleavage site, uh, that was... He told his wife that was the smoking gun, you know, and that he knew it was genetically edited. Since Nick Wade's piece came out and got a lot of attention, David Baltimore sort of walked that back and said, "Well, not really." Uh, and then other people have come out and said, "Well, you find furin cleavage sites and sequences in nature, and it doesn't necessarily have to be reflective of genetic editing." Um, you know, but there-

   17. PAPeter Attia54:46

       That's, that's been my find as well. I mean, I, I've-

   18. KEKatherine Eban54:49

       Yeah

   19. PAPeter Attia54:49

       ... spent far more time on this than I wanted to because-

   20. KEKatherine Eban54:52

       [laughs]

   21. PAPeter Attia54:53

       ... it's one of those-

   22. KEKatherine Eban54:53

       Everybody does.

   23. PAPeter Attia54:54

       Yeah, it's one of those things. You, you, you-

   24. KEKatherine Eban54:56

       Yeah

   25. PAPeter Attia54:56

       ... you sort of think, "Well, look, I'm gonna just read these three articles," and then the-

   26. KEKatherine Eban54:59

       Right

   27. PAPeter Attia55:00

       ... but then you have to read every single reference to those articles.

   28. KEKatherine Eban55:04

       Right, right.

   29. PAPeter Attia55:04

       And I mean, I, truthfully, I, I'm, I'm, I'm going out of my mind at this point, and I, I, I don't want to read any more on this because it's, it's too much. But y- you know, that's one of the rabbit holes I went incredibly far down. And-

   30. KEKatherine Eban55:18

       Yeah
8. 59:35 – 1:21:48

   Discerning what’s most important about both the zoonotic transmission and lab leak theories;

   1. PAPeter Attia59:35

      overwhelming. I think the most compelling-

   2. KEKatherine Eban59:38

      Wel- welcome to the club.

   3. PAPeter Attia59:39

      Yeah.

   4. KEKatherine Eban59:39

      Yes.

   5. PAPeter Attia59:39

      Yeah.

   6. KEKatherine Eban59:40

      Mm-hmm.

   7. PAPeter Attia59:41

      I think the most compelling mechanistic answer... So there's lots of circumstantial reasons, right? The-

   8. KEKatherine Eban59:48

      Yeah

   9. PAPeter Attia59:48

      ... Occam's razor says, you know, in the middle of fall/winter, so in Q4 of 2019, when there are no bats, they're all hibernating, you have a breakout n- in a major population center that's doing research on it. You know, so, so the, all of those things aside, from a purely biological mechanistic standpoint, I think the most convincing piece of evidence for a lab leak is that for about a year post this virus being in humans, it didn't change. We're only now seeing variants of this virus, right? Like the Delta variant you mentioned earlier. That strikes me as interesting given that, given the ubiquity of this virus, so how many people were infected-

   10. KEKatherine Eban1:00:41

       Mm-hmm

   11. PAPeter Attia1:00:41

       ... suggesting just how stable this thing was by the time it got into humans.

   12. KEKatherine Eban1:00:47

       Right.

   13. PAPeter Attia1:00:47

       Meaning a lot of the tinkering got taken out of it sooner. Um, now, so, so one argument would be if this were a virus that got manipulated and naturally-

   14. KEKatherine Eban1:00:57

       Mm-hmm

   15. PAPeter Attia1:00:57

       ... selected through humanized mice, which is to say-

   16. KEKatherine Eban1:01:00

       Right

   17. PAPeter Attia1:01:01

       ... mice that have ACE2 receptors in their lungs-

   18. KEKatherine Eban1:01:04

       Mm-hmm

   19. PAPeter Attia1:01:04

       ... which are the exact mice-

   20. KEKatherine Eban1:01:05

       Mm-hmm

   21. PAPeter Attia1:01:05

       ... you would use to do this type of research, in fact, the mice which we know were being used for this type of research-

   22. KEKatherine Eban1:01:11

       Right. Yes

   23. PAPeter Attia1:01:13

       That makes sense to me that, you know, you could easily have a virus that has now reached its state of maturation. It gets out now into, you know, the wild, um-

   24. KEKatherine Eban1:01:25

       Mm-hmm

   25. PAPeter Attia1:01:25

       ... and it takes quite a while to evolve into its, its new variant. Um, I- wh-what about you? Like, where does that stack up in terms of biological reasoning, uh, in favor of a lab leak versus not?

   26. KEKatherine Eban1:01:40

       So, you know, there, one scientist, Alina Chan, uh-

   27. PAPeter Attia1:01:46

       She's at the Broad

   28. KEKatherine Eban1:01:46

       ... has really ad-

   29. PAPeter Attia1:01:47

       Right.

   30. KEKatherine Eban1:01:47

       Yeah, she's at the Broad Institute, and she has really advanced that idea, and had a preprint paper to that effect, which is the idea that this virus seemed, um, immediately ready to infect humans, um, and didn't appear to undergo, uh, the sort of all the early mutations that you saw in SARS-CoV-1, right? So it seemed sort of primed for human transmission, which in her view argued for a lab leak. Um, but then you have scientists on the other side of that who say, "Actually, if you look at this strain, this, this is not maximized for human infectivity. If you were gonna set out to create this in a laboratory to maximize human infectivity, this isn't it." So I think those are, again, two competing, uh, versions of this.
9. 1:21:48 – 1:45:46

   Barriers to a full investigation;

   1. KEKatherine Eban1:21:48

      the, uh, World Health Organization, uh, partnered with a group of experts who went to China and were basically sort of led on this, you know, um, highly restricted tour, uh, by the Chinese authorities and issued a report, uh, in which they said, "Oh, the lab leak hypothesis is highly unlikely." I obtained a US government analysis of that report, which said, you know, the report is essentially ridiculous. It concludes that on the basis of, uh, no evidence, and in fact, one of the lead researchers on that expedition was Peter Daszak of EcoHealth Alliance. So, um, you know, there has not been a neutral-

   2. PAPeter Attia1:22:33

      Wasn't Peter Daszak the only American brought in? Wasn't he the only-

   3. KEKatherine Eban1:22:37

      That's right

   4. PAPeter Attia1:22:37

      ... American scientist brought in?

   5. KEKatherine Eban1:22:38

      Mm-hmm. Yes, he was. So there has not been a neutral, conflict-free forensic evaluation of all possibilities of origin at this time.

   6. PAPeter Attia1:22:53

      Do you have confidence that such a thing will happen? Um, the Biden administration recently requested, uh, such a report to be delivered within no less than 90 days, if I'm not mistaken.

   7. KEKatherine Eban1:23:06

      Yeah. Um, it is going to take a huge act of political will, uh, and really, u- uh, unity, uh, by many, many different countries to essentially force the Chinese to be more transparent. Um, it's not necessarily a fight that the Biden administration wants to have. It's really inconvenient. Um, I think it would be a whole lot easier to say, "Well, it must be zoonotic and we can't find the animal host. Bummer." Um, so, uh, you know, I don't know if we're gonna be able to surmount all of the political hurdles and the evidentiary hurdles, uh, that lay in our way to have, have a real investigation into this.

   8. PAPeter Attia1:24:04

      And what would be required of full transparency? What would, what would be, um... What, what would be asked for that would demonstrate conclusively one way or the other?

   9. KEKatherine Eban1:24:14

      Well, you know, part of that is what probably will never happen. China says, "You know what? We're changing our minds. Full transparency. We're putting back the database. Here's a record of all the samples. Here are the lab notebooks. Come do a tour. Here's the medical records of all the researchers who were in the laboratory." Um, uh, that is very, very unlikely to happen.

   10. PAPeter Attia1:24:45

       We, by the way, have no serology on the three people who worked in the lab who got sick in the late summer, early fall of 2019, correct?

   11. KEKatherine Eban1:24:56

       My understanding is that we don't, or if we do, if our intelligence agencies have something-

   12. PAPeter Attia1:25:00

       It's not public

   13. KEKatherine Eban1:25:01

       ... more definitive-

   14. PAPeter Attia1:25:02

       Yeah

   15. KEKatherine Eban1:25:02

       ... it's definitely not in the public domain.

   16. PAPeter Attia1:25:04

       Yep.

   17. KEKatherine Eban1:25:05

       So, you know. Plan B, assuming that China is not going to be more forthcoming, is for the countries of the world to basically look in their own research files, you know, that there is a lot of information that is potentially available to us if we are really to dig into our own filing cabinets. That is essentially what Joe Biden has called for. He's told the intelligence agencies to go back to the drawing board, um, inventory what they have, and see if they can't come to some sort of closer conclusion. Um, you know, there was recently, uh, an important paper, uh, put forth by Jesse Bloom, who is, um, an esteemed virologist, who said that there were sequences that were in an NIH database that were taken offline at the request of Chinese scientists that had some early, uh, uh, sequences from, uh, from Wuhan. So potentially, you know, there is information that our own government, for whatever reason, has either buried or ignored or removed, uh, which can be analyzed.

   18. PAPeter Attia1:26:23

       So given all the time you've spent on this so far, how has your own probability shifted from zoonotic versus lab origin over the past year?

   19. KEKatherine Eban1:26:39

       Right. Uh, well, you know, starting out, when a- anybody mentioned the possibility of a lab leak, my-- I was very dismissive because it sounded to me just like conspiracy theories. And there were a lot of conspiracy theories, um, associated with that. But I think what's happened is, as time has gone on, and no host animal has been found, and Trump has been removed, and so there's a sort of space to ask this question without necessarily aiding a, what's viewed as a racist agenda, um, you know, and China has failed to be transparent, and conflicts of interest have been exposed, you know. And from my own reporting now, I understand that a full investigation within the US government was essentially blocked or restricted. Um, you know, I kind of give it even odds at this point. I, I, I think it's a possibility. I don't have a definite conclusion. Um, you know, if a host animal was found tomorrow, I would be like, "Okay." Um, but I, I think there are just too many questions to be ignored right now.

   20. PAPeter Attia1:28:07

       You know, one of the things about conspiracy theories is they require cover-ups, you know? They-

   21. KEKatherine Eban1:28:14

       Mm-hmm.

   22. PAPeter Attia1:28:14

       Uh, you know, one of the, one of the conspiracy theories that's always obsessed me is the Kennedy assassination, uh, ever since I was a kid.

   23. KEKatherine Eban1:28:20

       Mm-hmm.

   24. PAPeter Attia1:28:22

       Um, and I don't know, probably by the time I was in my mid-thirties, I'd seen enough, read enough that I concluded there's simply no way it was anything other than Lee Harvey Oswald. Like I, I really just decided despite what Oliver Stone would have you believe, Lee Harvey Oswald acted alone. Um-

   25. KEKatherine Eban1:28:42

       Mm.

   26. PAPeter Attia1:28:42

       And there are many reasons I could bore you with that include a more accurate looking at, you know, a more accurate look at the forensics of, of the, you know, the, the, the ballistics and things like that. But a big part of it is how hard would it be to keep everybody quiet if this were some-

   27. KEKatherine Eban1:28:59

       Mm-hmm

   28. PAPeter Attia1:29:00

       ... CIA plot or some mob plot or, you know, one of the other crazy ideas that's put forth. And I guess that's one of the things that kind of nags at me here a little bit with this one, which is if this in fact came from a lab, how many people have to know that, right?

   29. KEKatherine Eban1:29:20

       Mm-hmm.

   30. PAPeter Attia1:29:20

       It, it's not the case, by the way, that, that Peter Daszak would nece- necessarily know that, right? He wouldn't necessarily know that. I mean, he, he might have a, a huge incentive to hope that it's not happened.

Episode duration: 1:45:46