Article Text
Abstract
Two years after the start of the COVID-19 pandemic, key questions about the emergence of its aetiological agent (SARS-CoV-2) remain a matter of considerable debate. Identifying when SARS-CoV-2 began spreading among people is one of those questions. Although the current canonically accepted timeline hypothesises viral emergence in Wuhan, China, in November or December 2019, a growing body of diverse studies provides evidence that the virus may have been spreading worldwide weeks, or even months, prior to that time. However, the hypothesis of earlier SARS-CoV-2 circulation is often dismissed with prejudicial scepticism and experimental studies pointing to early origins are frequently and speculatively attributed to false-positive tests. In this paper, we critically review current evidence that SARS-CoV-2 had been circulating prior to December of 2019, and emphasise how, despite some scientific limitations, this hypothesis should no longer be ignored and considered sufficient to warrant further larger-scale studies to determine its veracity.
- SARS
- COVID-19
- epidemiology
- public health
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Footnotes
MC and SB are joint first authors.
Handling editor Seye Abimbola
Twitter @OttoKolbl
MC and SB contributed equally.
Contributors MC, SB and AA conceived the initial idea for the manuscript, and MC wrote the first draft. All authors provided critical feedback and approved the final submission.
Funding This study was funded by Romeo and Enrica Invernizzi Pediatric Research Center, Università degli Studi di Milano, Milan, Italy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.