The source said the records are contained in a nearly 200-page annex posted alongside the WHO panel's March report that received little attention among global experts at the time. But the data may add weight to calls from China's critics for more transparency and to the WHO team's desire to return to the country for further studies.
No date has been set for the team's return to China, but the source said any future visit to the country -- where the virus emerged in the city of Wuhan, Hubei province, in late 2019 -- may involve "smaller groups supporting specific studies first." A larger group, similar to the 17 international experts that visited in January, might then follow up, the source added.
The WHO report's annex contains multiple data points providing an intriguing insight into China's evolving knowledge of the virus and the likely timing of its emergence.
It provides details of China's storage and destruction of positive Covid-19 samples from humans; a significant influenza outbreak that emerged in December 2019, at the same time as the virus; and the revelation that the first people known to have contracted the virus had contact with a total of 28 separate food and animal markets in December.
Animal screening
The team hopes to clarify data in the WHO report's annex, the source said, including a striking reference to wide-scale screening by Chinese authorities on animals susceptible to the virus, dated the first week of December 2019. The first human case of the virus acknowledged by China became ill the day after this testing, on December 8 that year.
On page 98, the annex says that on December 7, 2019, samples were collected from 69 kinds of animals including macaques, forest musk deer, porcupines and bamboo rats. The samples were tested in February 2020 for the virus that would later be labeled SARS-CoV-2 and found negative, according to a statement from China's National Health Commission (NHC) in response to queries from CNN.
The existence of the samples had not been publicly disclosed before the WHO team's report. The source close to the WHO panel said the coincidental timing of the sample collection had led their experts to remark "this is strange."
The entry may have been poorly worded, the source added. The source said the WHO panel had accepted the Chinese scientists' explanation this was routine screening, but the panel wanted to examine the raw data, as these samples had clearly been stored.
In its statement, the NHC said the samples referred to in the annex were collected between February and December 2019, as "before the coronavirus outbreak, relevant departments had been actively monitoring major animal diseases in artificial breeding factories of wild animals in Hubei province." It is not clear from the statement if the samples tested in February 2020 were from December 7 alone, or from a wider period in 2019.
The NHC statement added: "As part of the active surveillance network, the wild animal samples were collected based on the wild animals' activity routines, and other than the regular collecting and testing, those samples were stored properly as required. After the coronavirus outbreak, researchers conducted retrospective testing to those samples."
Excess mortalities
The source close to the panel said one potentially revealing part of the March 2020 report that still requires further examination was the excess mortality data in China provided for January 2020 -- which could show the first fatalities from the virus.
"The excess mortality numbers popping up in the third week of January in Wuhan, and a little bit later in Hubei, date back those infections to somewhere in the second half of December," the source said. "That shows substantial undetected circulation in December in Wuhan and then later in Hubei."
The source said the data showed the infection likely began in the city of Wuhan, the provincial capital of Hubei, and not in the rest of the province surrounding the city.
"You probably had already a few sporadic cases in November," they said. "But not in a substantial number -- therefore starting spreading very slowly and then expanding very slowly."
China's decision to destroy early samples of the virus is also laid bare in the report's annex. On page 116, it says early tissue samples of virus cases from one key Wuhan hospital, Xinhua, were destroyed early on in the outbreak. The source said the panel had established the samples were destroyed in the spring of 2020 and this was "a pity, as with retrospective thinking these samples are not available."
The annex says Chinese privacy laws prevented the samples from being retained. The source close to the panel also accepted the Chinese rationale for not having "hundreds of thousands of potentially live samples, sitting around in hundreds of hospitals and clinics" at a time when their health care system "was struggling at the height of the outbreak."
The strains on the medical system are apparent in the annex, too. It says Xinhua Hospital had a 40% rise in "outpatient visits at fever clinics" in December 2019, compared with the same month a year earlier. Multiple data points in the report and its annex reveal a widespread influenza outbreak in Hubei province and surrounding areas in late 2019.
Leaked documents reported by CNN revealed the flu outbreak in December of 2019, showing a significant spike in Wuhan but also other cities in Hubei at the end of that year. The cause and consequences of the outbreak of influenza-like illnesses remains unclear.
The source said the spike showed "there was a large influenza outbreak happening more or less at the same time" as the emergence of the coronavirus. The simultaneous emergence of the influenza outbreak with the first cases of the virus "explains the difficulties of identifying Covid cases in December and early January," said the source. It remains unclear the impact the influenza spike had on detecting the first cases of the novel coronavirus.
Patient zero?
Significant details are also provided in the annex on the first known case of the virus -- a person who is reported to have had onset of symptoms on December 8.
The annex gives, for the first time, greater details about the case: a man said to be an accountant working for his family company, with "no evidence for high-risk exposures (wild animals, mass gatherings, contacts with healthcare settings, contact with symptomatic individual, travel, etc.)"
He used public transport, but did not leave Wuhan, and had a relative working in health care. The annex says this first patient had no exposure to the Huanan seafood market, the animal trading hotspot thought to have played a role in the disease's first emergence. With further study, its centrality to the outbreak has become less clear, the annex reveals.
On page 178, the annex says only a third of the first cases had any exposure to the market, and about a quarter of the early cases which had any exposure to markets, had come into contact with a total of 27 other markets. The first patient had a relative who visited one "wet market," where live animals are traded. But the patient himself had no contact with any such "wet market," and in fact only visited an RT Mart -- a common chain grocery store -- in Jiangxia district, which was more than 20 kilometers (12 miles) from the Huanan market.
The source said the increased details on how few early cases had exposure to the Huanan market made it harder to establish its role in the first spread of the virus, but it did not completely "exclude the market as being an introduction point into Wuhan," they said.
A key challenge for the investigation, the source said, was how in early December only severe cases of the virus would have been noticed -- a small subset of the total people infected. "In early December, you must have had dozens, if not hundreds of cases, around the market that would never have been picked up," they said. "These could be the ones that would give us clues about the market's role in the city."
The source said the panel wanted greater access to the earlier cases and information about less severe, possible Covid-19 patients, if available. "It's been difficult to judge without having a clear understanding of the connection between all these cases. Some of them were friends or colleagues. And spending a lot of time together playing cards in between taking care of their shops. Others had nothing to do with each other."
In March, Ministry of Foreign Affairs spokesman Wang Wenbin said China commended the WHO team's investigation. "China has always been a supporter for global scientific research on the source of the virus and its transmission routes," he added.
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