Text/Phoenix News Client Honor Lead Writer Tang BargeHu
In the face of the shock of facts and laws, rumor-mongers with ulterior motives dare not continue to spread rumors openly, so they have to turn to dissatisfied muttering and pretending to be crazy and stupid.
As netizens said, rumor-mongers have bad intentions, and rumor-mongers are ignorant. It is necessary to investigate and punish rumor-mongers, educate rumor-mongers, and strive to fight the "epidemic" well and win a complete victory.
There are also netizens who do scientific research who leave a message, "Born as a Chinese scientific research scholar, we do not have time to think about the gossip of others, we must concentrate on saving lives for our people and doing practical things." Speaking with strength and speaking with evidence is the style of doing things that belongs to the Chinese. When the country is really strong, it is better, and his plot is in vain. ”
Well said.
Let us really and thoroughly reveal the details of the process of the new crown virus being truly introduced into the human world on the basis of the research results of scholars and doctors from all walks of life.
< h1 class="pgc-h-center-line" > who exactly is patient 0, and does it matter? </h1>
Now, some people are looking for the need to find out the channels of transmission of the virus in the hope of finding "patient 0" – the first case to be infected by an animal.
Some articles claim that patient zero of the new crown pneumonia has "disappeared" and "disappeared", and then launched a huge conspiracy theory.
Now, in the comments of various news sites and social media, you can see "Find Patient 0!" everywhere. "At all costs, get him out!" "Just want to know where the number 0 is" pointer.
To these raging and manic heads, I just want to sneer and sigh and say - what a bunch of the most easily instigated people, the best receptors for MLM implant control.
Because there is a knowledge gap between the general public and practitioners. At least it is necessary to use one basic knowledge after another to build a bridge board to overlap the past, in order to have a basic consensus vision.
Explaining this knowledge is more tiring, and it is impossible to explain it clearly in just a few words. But since I'm the lead writer of the public media, it's my responsibility to be concise and to the point—
Why in the large-scale infectious disease investigation, who is "patient 0" is actually not a very important matter.
< h1 class= "pgc-h-center-line" > lecture, starting with technical terms</h1>
First of all, in the mouth of epidemiologists, there is actually no such thing as "patient 0". They use both the terms "indicative case" or "primary case".
So dear keyboard virologists, please be professional in your outfit.
An Index Case is the first case to be identified and reported in an outbreak.
The significance of the indicator cases is that they have opened the curtain on public health control and investigation of the epidemic. The second is to provide the most direct and critical clues and tips for tracking the transmission chain of the epidemic, analyzing the causes of the outbreak and proposing control measures.
At the end of the previous article, we already know that the Index Cases of covid-19 are 7 cases reported by Xinhua Hospital on December 29 last year, 6 cases reported by Wuhan Central Hospital, and several cases reported by Wuhan Red Cross Hospital (Wuhan No. 11 Hospital, hosted by Union Hospital since last year).
All three hospitals are located near the Huanan Seafood Market and are the three closest public general hospitals to the Seafood Market. Most of the cases are directly related to the market.
Therefore, on December 30, the first notice issued by the Wuhan Municipal Health Commission after receiving the report directly connected the epidemic situation with the Huanan Seafood Market.
The next day, the last day of the year, on December 31, the first notification issued by the Wuhan Municipal Health Commission confirmed that 27 cases had been detected in the case search and retrospective investigation.
Primary case refers to the earliest case that can be traced back in epidemiological investigations after the outbreak is discovered.
Because the investigation of outbreaks is affected and constrained by environmental, human and social factors. Finding the primary case is a particularly difficult task. Best done early in the outbreak and when the number of patients is minimal.
The primary case is the starting point for the entire outbreak to be traced, but it is not necessarily the earliest source of infection of the epidemic.
Even if the so-called "first case" is found, in many cases it is difficult to determine that he is the first person to be infected by animals or the natural environment.
These days, the concept of incubation period and asymptomatic infected people has been popularized many times. I don't have to repeat it.
So, if you find the "first case", can you prove that there were no suspected cases and no asymptomatic infected people in the longest incubation period of 1 to 2 longest incubation periods before him?
Time has passed, how can these asymptomatic infected people who have been lurking silent at that time look for them? How do you prove it or not?
In addition, several meanings proposed in the so-called explosive article - "locking the source of infection", "locking the mode of transmission", "finding the secret of immunity to the virus", are not established at all, and it is basically a pseudo-expert speaking.
Therefore, in professional terms, English does not use Zero, 0, No.1, First, Chinese does not use the first, first, zero and other categorical adjectives, but English uses Primary, Chinese uses relatively vague language such as "primary", which is for this consideration.
The so-called "Patient Zero" is basically a concept created by popular culture.
So, naturally some people will ask, so don't you look for it? Isn't there any point in finding out?
In order to answer these questions and more thoroughly understand epidemiology, virus research and large-scale epidemic investigations in the modern sense, we must understand the history of AIDS, the most famous infectious disease that has been introduced from nature to the human world in modern history.
<h1 class = "pgc-h-center-line" > humans thought that finding AIDS "patient 0" took 3 years</h1>
In the summer of 1980, in California, the "white left" town of the United States, several men suffered from such disgusting diseases as Coppish sarcoma (KS), Pneumocystis carinii pneumonia (PCP), mucosal candidiasis, Cryptococcus meningitis, and disseminated cytomegalovirus infection.
Doctors found that they had common characteristics: first, the collapse of the immune system, and second, that they were all gay men.
Similar patients were later found in other parts of the U.S., and the U.S. Centers for Disease Control and Prevention (CDC) assessed and considered it an epidemic of a new disease.
The following year, on June 5, 1981, the CDC first reported on the situation in the Weekly Morbidity and Mortality, which became the starting point for AIDS to enter the human field of vision.
Initially, the completely ignorant medical community gave the disease a name — GAY Related Immune Deficiency (GRID). The American people simply call it "Gay Cancer."
At that time, we were in an era of gay and lesbian vigorous struggle for equal rights, and the public was inherently sensitive to the topic of homosexuality. The emergence of "gay cancer" has been hyped up as unforgivable evidence of homosexuality.
In this atmosphere, the 29-year-old patient, "Empty Boy" Gaetan Duga Dugas, a French national) took the initiative to stand up.
The image of Geltan Duga in film and television
Born in 1953, Duga became an Air Canada male flight attendant since the age of 20.
He is good looking and popular in gay circles. The convenience of his profession also allowed him to meet new people in gay places in various cities everywhere he went, such as gay bars and saunas.
Gaetan Duga Dugas) real life photos, is blonde
Unlike other patients' silence and blurred memory, Duga was very cooperative. He traveled from Canada to Atlanta (where CDC is headquartered) to undergo detailed biochemical inspections.
In addition, he has exploded a surprising sexual history with an astonishing memory, estimating that he has about 250 sexual partners per year, and a total of 750 sexual partners from 1979 to 1981.
He provided CDC with a list of 72 people whose names he can remember. According to the list, the CDC also found these people along the way.
The results of the examination showed that at least 8 people were already sick, including 4 in Southern California and 4 in New York City.
It is precisely because of Duga's active cooperation that the process of studying and understanding AIDS and its transmission routes has been greatly accelerated.
The paper, published in the American Journal of Medicine in 1984, said that the first four people living with HIV in California were infected by a homosexual airborne code-named "Patient O."
Epidemiologists hypothesize that it was The global Duga who brought the virus out of Africa and introduced it to the Western gay community.
In the subsequent spread, many people regarded the letter O as the number 0, so the words "Patient 0" and "Patient Zero" became popular.
(Here may also be influenced by the distinction between the roles of gay men 1 and 0)
<h1 class= "pgc-h-center-line" > all references and conspiracy theories</h1>
Randy Shilts, a journalist who covers AIDS, is writing a book about AIDS in the United States to explain how AIDS has swept the country.
At the same time, he also keenly felt that he could make a big fuss about this "patient 0". Subsequently, as an "insider", he quickly found the real identity of "Patient O" - Geltan Duga.
At this time, Du Gai, who had just turned 31, had passed away under the double torture of illness and public opinion.
Randy Shilts, 1951–1994
Based on the need to defend her own group, Randy Hirtz blamed half of the AIDS epidemic in the United States to CDC's "slow action" and "booty gay men," and the other half to Geltan Duggar.
The rest of him blamed the Reagan administration, the media's lack of attention, and the public's discrimination against us gay people.
Not only did he follow the phrase "Patient 0", but he also accused Geltan Duga of maliciously spreading AIDS as an antisocialist who deliberately spread the HIV virus and endangered his sexual partner.
In the new York Post's front-page headline, Dugas also became "the man who brought AIDS to us."
It is precisely because of the wrong label of "Patient 0" that all kinds of discrimination, insults, misunderstandings, and resentments of public opinion are vented on Duga's body, and even Duga's family, friends, and sexual partners are not spared.
Later, Hiltz compiled his report into a book, "And the Band Played On" (literally translated as "the band still plays," which is actually a lyric that condemns people for ignoring the problem).
Published in 1987, the book was nominated for the National Book Award, ranked 44th in the "Top 100 Journalism Works of the 20th Century in the United States" by the Department of Journalism of New York University, listed as one of the "Top 100 Non-Fiction Classics" by Time Magazine, and selected as the "Book of the Century" by the New York Public Library. Hailed as a grand epic, it has become a blockbuster bestseller, which can be described as a praise explosion.
In 1993, HBO made the book into a television movie, which received 20 nominations and 9 awards at the 1994 Emmy Awards.
Geltan Dugga in film and television
Fueled by blockbuster books, blockbuster movies and televisions, and headlines, the hats of "Patient 0" and "AIDS First Man" were tightly fastened on the head of the deceased Geltan Dugga.
Duga has naturally become the most notorious scapegoat in the history of the spread of infectious diseases in the world, and is considered to be the first AIDS patient to bring AIDS to the United States and spread the virus everywhere.
The first edition of the book in 1987 and the first edition of the Chinese, which was only published in 2019
At the end of last year, on December 31, almost in parallel with the epidemic, the book was translated as Chinese published in China under the title "The Cry of the Century : The Story of AIDS".
During the Spring Festival epidemic when the whole people were grounded, this new book was at the right time, and was sought after, innuendo, and sighed by the vast number of literary youth, and wrote down a long speech, notes, and book reviews.
But if I were to write a book review, I would like to write such a sentence - there are "conscience" epidemic reports, lack of scientific support, and in the end may deviate from the truth.
This book, as an early writing, lengthy and fragmented, sloppy early history of AIDS, casually look at it. But remember, the underlying basis, and even the backbone of the vein, is long outdated.
In fact, as a gay man, Randy Hirtz is an irresponsible person.
Before June 1981, the world was unaware of the existence of AIDS. Geltan Duga's "malicious spread" is simply not valid.
In contrast, Randy Hirtz, a full-time JOURNALIST covering AIDS, has been "in-depth" with gay men, but he has been deliberately avoiding HIV testing.
During the writing of the book, he finally got tested for HIV and asked doctors not to tell him the results until he had finished writing, so as not to affect his "objective judgment".
On the same day that he handed the manuscript to the publisher, he was told he was HIV positive. After a few years of taking anti-AIDS drugs, Hiltz died of AIDS complications in 1994.
< h1 class = "pgc-h-center-line" > humans find the real "patient 0" of AIDS, which took 35 years</h1>
As the investigation deepened, the CDC found that not only homosexuals, but also drug users, sex workers, and even housewives and hemophilia patients have similar symptoms.
In September 1982, the CDC officially named the disease "Acquired Immune Deficiency Syndrome", or AIDS for short.
In 1983, scientists isolated the pathogenic virus and named it THE HUMAN IMMUNODEFICIENCY Virus. Thus began the long sign of tracing the origin of the virus and preventing and controlling it.
But in the early days, this virus of unknown origin directly destroyed the human immune system and then summoned a variety of viral pathogens to exterminate the host.
Medicine at the time was completely helpless. In the face of great panic, helpless people can only blame conspiracy theories for the cause.
Conspiracy theories are divided into several views, the most mainstream of which is that HIV is a biological weapon made by the CIA and accidentally leaked.
A less important point is the product of the remnants of the Nazis or of some mad scientist trying to genocide and establish a new world order.
After the collapse of the Soviet Union, declassified russian and East German archives confirmed that "made by the CIA" was a means of public opinion warfare led by old rivals kgbs and Stasi (East German intelligence agencies).
With the advancement of genetic technology, field investigations in Africa, and epidemiological traceability, scientists are finally approaching the truth step by step:
(Space limitations, here mainly only talk about HIV-1, not in-depth discussion of HIV-2)
In 1999, scientists finally confirmed a long-standing conjecture at the genetic level that the virus came from orangutans in Africa, and many monkeys and orangutans in Africa carry different but similar ape immunodeficiency viruses (SIV).
The researchers found a branch of SIV, SIVcpz, in a chimpanzee, a virus that is very similar to hive in humans. It can be determined that in Africa, cross-species infections with humans have occurred.
In 2003, scientists traced further down the source of the SIV, and found that chimpanzees preyed on two other species of monkeys, a red-crowned white-browed monkey and a spot-nosed long-tailed monkey.
The two monkeys have two different SIV viruses (relatively harmless), and chimpanzees may be infected with the two SIV viruses when preying on the two monkeys. When these two SIV viruses combine, they become a third virus, called SIVcpz.
SIVcpz can be transmitted between chimpanzees, as well as humans.
The bigger breakthrough is that after 2010, with the rapid decline in the cost of gene sequencing and the increase in speed, scientists can carry out gene sequencing on a larger scale and a wider population. Many subtypes of hive virus are understood, so that the conditions for inverse deduction of evolutionary trees are available.
It follows that the SIVcpz virus was introduced to humans from orangutans around 1908 (confidence interval 1884-1916). And not an isolated pathway, with at least 7 major incomings estimated by subtype analysis.
On the other hand, scientists began to test them with amplification technology on historical blood samples and human organ collection samples preserved in the early years of hospital archives in Africa and the Americas.
Finally, I was surprised to find that as early as 1959, the earliest people were found to be HIV-positive in a blood sample in Kinshasa, the capital of the Democratic Republic of the Congo.
In the 1968 American blood sample, a young man named Robert Rayford, who was only 16 years old at the time, also left the HIV virus.
But the young man never left the Midwest, suggesting that HIV was widespread in the United States before 1968.
Scientists examined more than 2,000 samples from the 1970s and estimated that in 1980, there were actually 50,000 to 100,000 people living with HIV in the United States.
Finally, these research results saw a big outbreak between 2013 and 2016, allowing people to completely understand the whole process of HIV transmission:
It was transmitted to Kinshasa from tribes in the Congolese jungle from 1924 to 1930, mainly through sex workers.
Kinshasa, 1974
After Congo's independence in the 1950s, a large number of Haitians traveled to Kinshasa in search of job opportunities and brought the HIV virus across the Atlantic to Haiti.
In the 1960s, the United States entered the Vietnam War, and the demand for plasma soared. Haitians sold blood to send plasma containing HIV to the United States.
Next, that's the story in America.
There are also scientists who have "bones clear" all the way, directly traced back to the real "patient 0" of the HIV virus -
About a million years ago, there was a chimpanzee that fought two different monkeys in a row and was injured. The two monkeys themselves each carry the SIV virus that is prevalent in their own populations.
Originally, these viruses alone entering the chimpanzee's body will be eventually destroyed, but in the body of "Chimpanzee No. 0", fragments of these two viruses have recombined and begun to multiply for a long time, leading to the birth of a new SIV virus.
Check it out, from Geltan Dugga in 1981, to Kinshasa in the 1950s, to black tribal hunters in the Congo rainforest in the late 19th and early 20th centuries, to a chimpanzee (controversially) 1 million years ago.
The real "Patient 0" traced back to the source, what a long distance!
<h1 class = "pgc-h-center-line" > most powerful weapon</h1>
Genetic sequencing is the most fundamental and powerful weapon to uncover the source of the virus. Of course, genetic sequencing alone, without combining epidemiological investigations, can lead to erroneous conclusions.
In the past two days, many friends have sent me a newly published paper, saying that there is a discrepancy with my reasoning.
Let's put it this way, in the past month, I have read most of the important papers published by scholars from all over the world on the NEJM (New England Journal of Medicine), Lancet (Lancet), and important biological papers preprinted BioRxiv, medical papers preprinted MedRxiv website.
Know which are important papers, which provide new evidence, which are funny to run over —
For example, the indian scholar's paper said that the new crown virus found that there are 4 base sequences that can also be found on HIV - 4 bases are the same and want to make a big news? It's so sensational!
Here I can give a conclusion in advance: the papers that have been circulating in the past two days are not accurate in terms of arguments, inferences, and conclusions. Because it did not combine the facts of clinical and public health, it was wrong to deduce in a certain link.
Tomorrow, I will finally deduce the key details of the introduction of the new crown virus into the world, that is, the final reveal. All remaining doubts and problems will be finally resolved.