When it comes to safety in healthcare, rules, regulations and guidance are essential to help secure protection for patients and healthcare workers. For example, the Health and Safety Executive (2023) and the Royal Pharmaceutical Society (2023) address the safe handling of cytotoxic drugs in the workplace and the safe and secure handling of medicines, respectively. These types of initiatives to reduce the risk of potentially hazardous procedures derive from a tacit acknowledgement of the fact that human frailty is an ever-present aspect in all fields of endeavour.
An example of this concerns the ongoing debate over the origin of the causative agent of COVID-19, SARS-CoV-2. Calisher et al (2020) wrote to a prominent medical journal indicating in a statement both their support for ‘the scientists, public health professionals, and medical professionals of Wuhan and across China’, and making clear that ‘[w]e stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin.’ However, as Birrell (2022) notes, a co-signatory to the statement later condemned ‘Wild West’ research in Wuhan. In addressing the involvement of the National Institutes of Health (NIH) in Wuhan-related research, Harrison and Sachs (2022) call for an independent inquiry into the affair, observing that the NIH ‘has failed to reveal to the public the possibility that SARS-CoV-2 emerged from a research-associated event, even though several researchers raised that concern on February 1 2020, in a phone conversation that was documented by email.’ Interestingly, in a pre-COVID-19 article on the Wuhan laboratory, Cyranowski (2017), cites a biosafety authority who comments ‘that an open culture is important to keeping biosafety level-4 labs safe, and he questions how easy this will be in China, where society emphasises hierarchy.’
Given this fraught context, it is perhaps worth considering that the French philosopher Jean-Francois Revel (1924–2006) coined the term ‘retrospective clairvoyance’ to describe the deductive power of pundits in predicting the inevitability of an event that occurred in the past (James, 2007). It is a phrase that has a disconcerting resonance because in July 1978, Pike (1978) asserted that ‘[t] he introduction of protective devices and emphasis on safe procedures seem to be reducing the risk of accidental infection.’ Weeks later, on 24 August 1978, Prof Henry Bedson of the Department of Medical Microbiology and Virology at Birmingham University analysed samples from 40-year-old medical photographer Mrs Janet Parker – who worked in the Anatomy Department on the floor above Bedson's smallpox research lab – and confirmed that she had smallpox; on 1 September 1978 Bedson entered his garden shed and attempted to commit suicide, dying five days later; and on 11 September 1978 Janet Parker succumbed to the disease (Griffiths, 1998).
Griffiths (1998) speculates that one reason for Mrs Parker becoming infected is that the virus could have ‘been transmitted through the service ducts which connected the smallpox laboratory with the Department of Anatomy on the floor above [where Mrs Parker worked].’ Griffiths (1998) makes two further observations that are relevant in today's COVID-19 context. First, once news of the smallpox incident emerged, there was a clamour for vaccinations in Birmingham, and ‘[h]oliday destinations such as Italy and Malta refused to accept British tourists unless they came armed with a certificate of vaccination’ (Griffiths, 1998). Second, we learn that the Advisory Committee on Dangerous Pathogens had published a Code of Practice in 1976 ‘following a similar outbreak at the London School of Tropical Medicine [sic] in 1973’ (Griffiths, 1998). The advisory committee of dangerous pathogens demanded stringent controls over agents like smallpox, using measures such as airlocks, negative air pressure, air filtration, showers, and effluent sterilisation. None of these measures was in place at the Birmingham lab, yet one of the Advisory Committee of Dangerous Pathogens members was… Prof Bedson.
Laboratory containment measures have changed over the last 45 years, but what has not changed is the universal propensity for human folly to which none of us is immune. It is correct that, as Harrison and Sachs (2022) suggest, a full and independent inquiry regarding the origin of SARS-CoV-2 is undertaken, because it appears that laboratory, medical and governmental politics are involved.
As the historian Prof Ivan Illich observes, a government ‘that bases its decisions on expert opinions given by professions might be government for, but never by the people’ (Illich et al, 2000).