Thank you, gharris, for originally posting this information on the Aug23 news thread at 17:13.
WHO procedures for obtaining release of H5N1 sequences to the public domain
23 August 2006
…”Currently, the genetic sequencing of H5N1 viruses is a product of collaborative work between national or other laboratories receiving specimens in countries with outbreaks and the international network of specialized H5 reference laboratories coordinated by WHO. WHO seeks permission from the country that provides the virus to place the sequence information in the public domain.
WHO believes that timely sharing of H5 virus sequence information is a critical step for improving the international response to the avian and pandemic influenza threat. In its coordinating role, WHO seeks to facilitate the timely release of sequence data to the public domain, such as the Los Alamos National Laboratory (LANL) Influenza Sequence Database and GenBank. Formal procedures exist by which the WHO reference laboratory initially informs the originating laboratory of sequence results and simultaneously requests permission to place these results in the public domain. In the event of a negative reply or no reply, WHO directly approaches the Ministry of Health in the originating country, requesting authorization to release sequence data.”
IMO, by publicly stating the procedure (and thereby defending itself), the WHO is applying pressure on individual countries. A welcome development.
However, the way the WHO wrote this information implies that all genetic sequencing is done this way (first sentence above). It took me a couple of read throughs to realize there are two ways for a country to be less than transparent. The first is to not authorize the WHO to release the sequences. The second is to simply not provide the virus specimens to the WHO reference laboratory in the first place. The WHO procedure only kicks in if they have a specimen.
So a country, especially one where the WHO has not been invited in during an outbreak, could falsely appear transparent by letting WHO release the sequences on the specimens they’ve provided to the WHO lab, while withholding other virus specimens at the same time. Do I have this right?
Thanks gharris and Nighowl for posting this. Some time back I suggested that the WHO should do this. So, I would be remiss if I didn’t praise them for doing it. This is a huge improvement over the old policy.
Nightowl, I think your interpretation of the loophole is correct. And the country in the best position to use it is China. Now that the CDC has finally agreed to release their sequences, it is time to renew our call for complete transparency from China.
Let’s start by getting the sequences from Shi the solider, the first reported case of H5N1 in mainland China. The paper was published in the New England Journal of Medicine. Why weren’t the sequences released? What is the Chinese goverment hiding?
Is there something in those sequences that would be emabarassing to them?
Hello Monotreme & group - you wrote at 10:11: Now that the CDC has finally agreed to release their sequences,
It’s my understanding the CDC will only be releasing sequences acquired from the U.S.A. The article posted at this ProMed link says:
‘’The information added will include viruses from the annual flu season in the United States, any animal influenza viruses that infect humans and any novel strains that may emerge such as avian influenza H5N1. The new agreement will only apply to viruses isolated in the United States.’‘
And, it is followed up by an astute ProMed moderator comment: [This is a welcome and valuable initiative, although to some extent it is devalued by its restriction to viruses isolated in the United States. - Mod.CP]
Hopefully this clarifies what the CDC is doing…er, not doing or not able to do…regarding sequences from outside the U.S.A.
beehiver – at 10:35
You’re correct. But there are other iniatives that will force the CDC to release at least some of their other sequences, for example, the Indonesian sequences are being released.
The battle is not won, but things have definitely improved.
Monotreme, I hope you are correct that additional efforts will force the CDC to do that. It seems the devil’s in the details regarding this whole problem. I’m finding it interesting that Indonesia is now sending seqs to the CDC, and while trying not to be overly judgmental, is this yet another manuveur to delay release of seqs, or perhaps some back-room deal going on with officials in Indonesia? Honestly I am trying to think positive about all this, but am getting tired of the same-old same-old going that’s been going on for so long. I’d like to think it’s not all about money or glory and fame. But as one scientist said this past week, the monitoring, response and information release regarding H5N1 needs to be happening in a much more timely manner, if we are going to have a chance at dealing with it at all.
Sorry for the rant. My patience is wearing a bit thin.
Beehiver. As I have said in the past, my hobby or obsession is finding patterns…it appears that we have a trend-line building at the moment…if independent scientists and non-independent scientists all over the world are ‘lossing patience’ than in my mind, that is a good thing.
Tom DVM, I fully agree. Some important signals picked up on this past week, are the fact that a few scientists are beginning to speak up. For instance, Dr. de Jong warning about indiscriminate use of Tamiflu blanket. He was one of the lead scientists doing the research in the case of the Vietnamese girl who developed a second Tamiflu-resistant strain while being ill with H5N1, and died from the second strain (the researchers isolated and sequenced both strains). The case is detailed in this article. De Jong is certainly qualified to know what he is talking about.
The point being, when scientists start sounding warning signals - my antennae go on high alert.
There are already ruomors being floated from some scientists that the virus is now changing in some more or less significant way. In itself, that’s not surprising, because that’s what influenza viruses are good at. Certainly the fact that we are seeing one or more suspected or verified new cases nearly everyday in Indonesia, is clinical indication the virus is changing in some manner. And it’s probably been happening elsewhere, under the smoke.
I have a question:
“Formal procedures exist by which the WHO reference laboratory initially informs the originating laboratory of sequence results and simultaneously requests permission to place these results in the public domain. In the event of a negative reply or no reply, WHO directly approaches the Ministry of Health in the originating country, requesting authorization to release sequence data.”
When I read this, it doesn’t say to me the WHO is establishing new procedures or rules or guidelines, just that ‘formal procedures’ already ‘exist’. And it does not sound any different from previous provisions under the International Health Regulations.
I read this as more of a bland statement to cover their backside and say “well, here’s what we do”. But what they do is nothing more than ‘requesting authorization’. The WHO reference labs still cannot automatically release the sequence.
The cynical me thinks this is a directive to make sure scientists of WHO reference labs do not release the sequences without authorization from the countries.
How is that different from before?
It also means authorization has to be obtained explicitly every time. Which gives everyone the chance to drag out the process, as ‘formal’ aka diplomatic procedures can be spun out over long periods of time.
Which was exactly the situation we’ve been having.
Methinks this is the WHO peeing over the boundaries to say “this is my territory, ain’t nobody allowed to muck around in here.”
“WHO peeing over the boundaries…”
anon 22…I am shocked…/:0)
Can you feel yourself starting to move…over to the dark side…it is only a matter of time till you are cursing at the WHO as much as myself and Monotreme…give in anon 22…it’s only a matter of time.
Tom DVM – at 15:02
How does a rhino protect it’s turf?
I suspect that Anon_22 might have intended it to say “peering over the boundaries….” but at the moment I am laughing too hard to be sure! :-)
Lauralou – at 15:32
Ah, but …… muck around?
Some times you can only take so much sugar.
ANON-YYZ- at 15:36
I think you are correct. Peeing it is! (and I have to say that my patience with the WHO ran out months ago.) However, that is about the best laugh I’ve had in days!
Tom & Lauralou,
Both of you have too little confidence in my ability to shift between the dark and the light.
:-)
Nightowl – at 05:05 wrote:
Thank you, gharris, for originally posting this information on the Aug23 news thread at 17:13. WHO procedures for obtaining release of H5N1 sequences to the public domain 23 August 2006
…”Currently, the genetic sequencing of H5N1 viruses is a product of collaborative work between national or other laboratories receiving specimens in countries with outbreaks and the international network of specialized H5 reference laboratories coordinated by WHO.
I would imagine the those interests that pay for the laboratories and the salaries of the scientists, have significant input as to what commincated. Follow the money. Increasing the pandemic level another notch would cause the Indonesian economy to tank and increase the possiblility of a domino effect in global markets. But then, I could be wrong and so could the World Bank.
(excerpt)
Aug. 24 (Bloomberg) — Rich countries need to help fight bird flu in Indonesia, where the virus has killed an average of one person a week this year, because it poses a ``quite severe’‘ threat to its economy, a World Bank official said.
Tom DVM – at 15:02
“Can you feel yourself starting to move…over to the dark side…it is only a matter of time till you are cursing at the WHO as much as myself and Monotreme…give in anon 22…it’s only a matter of time.”
:-)
I like the assumptions you make behind that question.
I don’t get mad as much as you and Monotreme do at the WHO not because I have any fondness for it, but because I know it for what it is.
Perhaps I can give an analogy. If it is in the nature of tigers to hunt down and eat zebras, do you get mad at the tiger for doing so?
Stuff that you guys complain about, I don’t like them either. But the whole UN system is the way it is, and worse things have happened in its name. Doesn’t make it right, but it doesn’t deserve a disturbance of my tranquility and wasting my very limited time.
So from time to time I will point out on this forum the nature of the tiger; don’t be fooled by what it says. Read carefully everything that you encounter. Interpret it always in the context of the UN/World Health Assembly system, and not according to how you think it should be.
Monotreme – at 10:11
“‘’Let’s start by getting the sequences from Shi the solider, the first reported case of H5N1 in mainland China.’”
You may already know this but the first reported case of H5N1 originating from Mainland China happened before this soldier. This was the family cluster from Hong Kong visiting Fujian in February 2003, with the daughter dying of unknown causes in China and a father and I think an younger brother confirmed positive when they returned to Hong Kong. (A/HK/212/03 and A/HK/213/03)
I definitely have a different take on this. By, moving the information out of the health regulation arena, where the information is read by the few, and posting it on their website in a form that can be read by the many, they are providing the means for the public to oversee and question the process. (I agree, as I stated above, that there is an element of defense.) I see it as instructive to the world audience as opposed to their reference labs who already know the procedure.
For example, knowing that the lab has to receive the specimen provides Checkpoint One for us to watch.
Checkpoint Two is in the paragraph Anon_22 cited, where it states that when the WHO reference lab that sequences the specimen reports back to the originating lab, they “simultaneously” request permission to release from the lab. If the lab is pre-authorized, it’s a go, and they don’t need permission from the ministry. In other words, applying Indonesia, it looks like their labs can authorize release without having to go up the ladder now. We can also track whether the reference lab is following procedure or sitting on the sequences.
Checkpoint Three is where they have to go to the ministry.
As Anon_22 has pointed out, the time factor and ability to drag out the process can plague the process every step of the way. But once again, we are alerted to the pressure points. We should have a reasonable idea of how long a given process should take.
Now I’m going to use China and the NEJM as an example. Checkpoint One is whether a WHO reference lab received the specimen. This is tricky.
…”In line with WHO recommendations, confirmatory testing in a laboratory affiliated with the Ministry of Health was arranged. Following an official request, WHO sent laboratory experts to consult with national experts performing the tests. That joint undertaking, conducted in late July, confirmed the man’s infection with the H5N1 virus”… (from WHO Situation in China, Update 13)
It looks to me as if China may have circumvented the procedure (a laboratory affiliated with the Ministry of Health and calling WHO experts to it as opposed to sending the specimen to a WHO reference lab such as Hong Kong). China’s Ministry of Health is the pressure point. If China had authorized the release, and the sequences were held up by scientists at a reference lab, then the lab would be the pressure point (possible example: Indonesia). The odd thing is that I can’t find the name of the lab in China that confirmed the NEJM case. Seems deliberately left out of all press releases. For all I know, the Ministry of Health lab is also a WHO reference lab (Hong Kong), but we can find this out.
The bottom line is that I am less concerned as to whether the WHO procedures are new or old. I am appreciative to the WHO for making the process more accessible to the public. By educating the public, the number of people watching the process can increase dramatically. I believe they do deserve praise for this.
However, it doesn’t stop me from being critically aware that the WHO stops short of simply posting where the sequences are in the process. They could do this in their situation updates: “The WHO reference lab in X location received a specimen from X country today to sequence.” Or “The WHO reference lab sequenced X countries’ specimens and requested permission for release today” and so on. A thread on what we would like to see in terms of WHO transparency and the procedure would be good perhaps.
Nightowl,
“If the lab is pre-authorized, it’s a go, and they don’t need permission from the ministry. In other words, applying Indonesia, it looks like their labs can authorize release without having to go up the ladder now.”
Do we know for sure that any country has pre-authorized the release of sequences in this way? If you know, can you provide the source? I would be very surprised if countries are willing to do that. I would of course be very happy but I won’t believe it until I see it :-)
Nightowl,
With regards to China and the NEJM business, FYI China is the only country which does not send specimens to outside labs. Current WHO procedure requires confirmation of H5N1 infection in humans to be confirmed by a WHO reference lab outside of the country where the sample originated. China is the only exception, and WHO accepts China’s word when told that there is or is not a confirmed case of H5N1.
Under the UN, sovereign countries are equal entities. It seems also that some countries are more equal than others.
The World Health Organization was Okay as long as they were doing no harm…well they are doing harm…a lot of harm…some of which we have discussed over the last six months…some might say ad nauseum.
What it has come down to, in my opinion, is that it is either them or me and since I don’t intend it to be me (us the collective) then it is going to have to be them…
…and if they don’t mend their ways and this pandemic hits the way I expect it to…then they are not…not going to hide behind that cute little mandate that some might interpret as an escape from responsibility clause.
This is not going to be like SARS repeated in a lot of ways. One of the ways is they are not going to reinvent history and escape their share of the blame this time!!
Tom,
I wish ‘share of blame’ is enough to move things in international politics. I really do. But I look at everything that’s happened in the world and I’m very pessimistic that things will change much by public opinion alone.
The only things that will cause countries like China or Indonesia to act differently are benefits and concessions that other countries are willing to trade for. Right now, the US which is the biggest kid on the block has very few marbles in its pocket to trade with anyone. The rest of the developed world eg the EU has even less. And everyone knows that. China and Indonesia (NB for Indonesia also read ‘the Islamic world’) are in strong bargaining positions if you want them to do anything differently.
beehiver – at 10:52 “I’m finding it interesting that Indonesia is now sending seqs to the CDC, and while trying not to be overly judgmental, is this yet another manuveur to delay release of seqs, or perhaps some back-room deal going on with officials in Indonesia?”
They are sending sequences only to the CDC as opposed to sending both to the CDC and to Hong Kong before. The only effect of that is to cut the Chinese off from early access to their data.
Annon 22 It has been apparent since last February when I popped in for one post and am still here, that you and I are probably equally frustrated and have been ever since then.
So here is what I want. I want the World Health Organization TO STOP LYING, to stop deliberately misleading, to stop spinning every piece of information that comes along, I want them to stop setting themselves up as the excuse by which my regulatory agencies and governments use to sit on their hands and do nothing…
…that is a pretty simple request…I am asking them to be scientists, not the politicians and by the way bad politicians they have been for the past five years…
…If they don’t have control over the sequences say so…If a country won’t do the right thing say so etc. etc. etc.
I want them to use scientific principles, method and philosophy…and when they do and break themselves out of their lazy habits then I will get at the front of their parade and raise the UN flag and be a proud citizen of the world.
What do you think the odds are of this simple request being fulfilled?
“We will let you look at the sequences first in return for tamiflu.”
Maybe.
Tom DVM – at 17:50
“I want the World Health Organization TO STOP LYING”
Sorry to be cynical. You might as well want the earth to stop spinning.
Never forget the origin of the WHO. An offshoot of any entity will always bear characteristics of that entity.
WHO is an offshoot of a diplomatic entity.
You expect those folks to tell the truth????
Okay ANON YYZ. I’ll bite…how does a rhino protect its turf?
annon 22 Point well taken…but we (the collective of scientists) have to stop appeasing them or we become complicit by our silence!!
We are not appeasing them. I am going around telling it like it is.
That for example as far as this issue is concerned, this recent announcement indicates that the WHO is not doing anything differently.
Anon_22 at 17:34 - Thank you for confirming that China does, in fact, circumvent the procedures. All the more reason for us to be skeptical about any information they put out without outside confirmation. Also, if you could provide a link to the source of your information, I would appreciate it.:-)
Anon_22 at 17:30 - Regarding the pre-authorization of release at the lab level: I do not know for sure if any country already does that, which is why I said “looks like” in regard to Indonesia because that is how it looks to me now, but it didn’t look that way in the past. I certainly could be wrong. I cannot provide any source to confirm. But it would be nice if we could.
The WHO’s phrase “in the event of a negative reply or no reply” implies that the procedures anticipate some originating labs being able to give permission to release sequences without government approval. Otherwise, why even put it in the procedures? Why not go straight to the ministry every time? It doesn’t mean that the current countries with outbreaks are doing this now or that future countries won’t IMHO. As things countinue to get more time-critical, we may see a lot of changes.
I think the WHO was wise to include this option. Further, in some countries, authorization from the government may not be needed at all. Would Webster have to get authorization from the U.S. government to release sequences? I don’t think so.
Nightowl – at 19:02
“Anon_22 at 17:34 - Thank you for confirming that China does, in fact, circumvent the procedures. All the more reason for us to be skeptical about any information they put out without outside confirmation. Also, if you could provide a link to the source of your information, I would appreciate it.:-)”
The following is from WHO guidelines for global surveillance of influenza A/H5
“WHO also recommends that the first positive laboratory identification of influenza A/H5 virus in humans in any country or territory be confirmed by one of the WHO reference laboratories for diagnosis of influenza A/H5 infection (see Annex 6).”
“In addition, and until further notice, WHO requests that all human influenza A/H5 virus isolates or samples be sent to one of the WHO reference laboratories for diagnosis of influenza A/H5 infection (see Annex 6).”
“Only information regarding confirmed cases will be made available in the public domain.”
When you go and read the updates, especially the earlier ones with more details of samples sent, you realize that every confirmed case was confirmed by a WHO reference lab. Except for China, like here or here. Recent cases were announced to the world by the Chinese authorities telling the Hong Kong government and then the WHO.
With regards to your comments on authorization, you are still reading this business in an altruistic way. :-) We discussed this rather extensively a while back here under the International Health Regulations.I would be very surprised if Webster does not require authorization from the government to release sequence information. Remember that until now the CDC has been operating a ‘no disclosure until proven otherwise’ policy. The NIH has had a different policy for a while, of depositing everything in GenBank.
These are legal issues which can be changed at the discretion of the institution or country but not at the discretion of individual laboratories or scientists.
anon_22 – at 19:50 wrote:
“These are legal issues which can be changed at the discretion of the institution or country but not at the discretion of individual laboratories or scientists.”
Put another way - follow the money. Who pays for the labs and the scientist’s salaries? If bad news emanates from those labs, it might compromise the ability of some parties to continue paying for those labs and salaries.
Anon_22 at 19:50 - Thank you for the links and the excellent tracking and analysis of China in regard to sequence release. Confirmation enough for me.
Regarding Webster, I was speaking about U.S H5N1 sequences in the future. Sorry, obviously, I wasn’t clear.
Regarding your “patronizing with a smile” comment repeated here: “With regards to your comments on authorization, you are still reading this business in an altruistic way. :-) “
I will only say I had a good LOL as I have been such a critic of TPTB on this forum from the WHO on down. I’ll take it as a compliment.
The WHO may have non-altruistic reasons for their statement, but the question is, can we use it to our advantage? I think yes. For example, we can say it is the Turkish government that is witholding the sequences from the human cases. So, let’s boycott Turkey! Now, I am perhaps being naive about the details of why Turkey has not released the sequences, but that might be deliberate ;-)
I say we go after every country that does not release sequences within 1 month of sequencing (that is more than enough time to deposit them). Our response should be harsh and unforgiving. If we inflict enough pain on the relevant countries, perhaps they will release the sequences (or reveal other things of interest). In any case, I’m going to interpret that WHO statement without parsing it too carefully.
Speaking of which…
China still has not released the sequences of Shi the soldier. Why not? He wasn’t involved in a bioweapons program, was he? Why is China hiding the sequences from the virus that killed this soldier?
They are selectively releasing some sequences but not others, retracting some sequences, but not others. Attempting to block some papers, but not others. Only thing that makes sense to me is the Chinese government has something very bad to hide. Like a bioweapon (or a vaccine against a bioweapon) gone horribly wrong.
Nightowl,
It WAS meant as a compliment. :-)
Monotreme - I want to know why China is not disclosing the sequences of the soldier as well. Are all the sequences released for the other human cases that we know about?
I’m ready to flood the Chinese embassy with letters. The press would definitely pick that up. All we have to do is provide them with a copy of the letter. Even mail copies to the various state run presses in China. Plus Taiwan, Macao, and Hong Kong.
DemFromCt has just posted a link on the CDC thread to an absolutely must read article in Nature regarding sequence release. I am reposting his link here.
Nightowl.
“I’m ready to flood the Chinese embassy with letters.”
I have been watching and analyzing China with respect to food quality, safety and a variety of pathogens very carefully for seven years…
…THEY DON’T CARE!!
even if there is no juristic pressure, it seems there is some public pressure building to release the sequences. Those who don’t will be marked more effectively as “evil”. Hey, let’s share the data ! You get all the data from other countries but you should also give us yours ! Then Indonesia might say :… but we have more data than the others, that’s unfair. And China might say: we have no more data - and noone beleaves it. But it’s a step forward when countries in principle agree that the data should be public. Next year Indonesia could be birdflufree and Vietnam is again a hot spot or India turns into secrecy, then Indonesia and China have few arguments to require the release. So it’s good to agree now on the principle. I would also advocate a premium for the release of each sequence. And a list on the WHO webpage which country has shared and withheld how many sequences.
what’s the reason for the 6 month’s delay, how is it justified ? They want to hide the possible emergence of pandemic danger as long as possible ? Or they want to ensure that noone else can publish something ? If it’s the latter, they should really find another solution to protect the copyright of the submitter. It can’t be that difficult.
Nightowl, China has released a few sequences from some of the patients, but have not released most of them. Tom DVM is right that they may not care, but it wouldn’t hurt to let them know that we have noticed. They cannot hide behind the WHO anymore. They can’t say the Americans are hypocrites anymore. They can’t say most other countries are hiding their sequences anymore. Even poor corrupt Indonesia is releasing it’s sequences. China’s refusal to release their sequences looks increasingly sinister.
One thing I am curious about is why the New England Journal of Medicine (NEJM) did not require the authors to release the sequences from the soldier. Most journals require this upon publication.
Perhaps it would be worth asking them. Here is the NEJM contact page.
Here is the editorial contact information.
Here is a link to the paper. Fatal Infection with Influenza A (H5N1) Virus in China. It is especially important to get the sequences from this virus as the paper refers to it as a “mixed” virus.
These findings suggest that influenza A/Beijing/01/2003 may be a mixed virus.
This is odd terminology for virologists to use, I think. Do they mean it is a reassortant or something else? How is it that genomic segments from viruses from different regions of China got together in Shi the soldier? Enquiring minds want to know.
TomDVM - I know. :-(
I am one of the go down fighting types. China may be more sensitive to bad press with the Olmypics coming up. Maybe your eighth year will be the one. At least we can keep calling them on their game. Like signing onto the letter about the new sequence database, but still haven’t released the NEJM sequences. (I just read the news thread; I sure am late to the party on the Nature article and Klatu’s Maria Cheng piece. That will teach me to check the news thread earlier!)
the real worms are from China, right ?
Monotreme. The only thing they are worried about at the moment is that their coming out party, the Olympics in 2008 are not affected by bad plublicity…
…If you want to get them…link it to the Olympics.
By the way…they also do not care whether we tell them “we have noticed” or not…
…it’s just another reality we must face and understand to move forward.
Let me put it another way and I will only say this once because I don’t want to be considered a Chinese citizen basher when I really am only a Chinese Government basher and maybe sometime I will get a chance to tell the whole story and you will understand that my opinions are based on sound evidence.
I ask you to consider the following philosophical question.
What makes you think that a Government founded on the machine gunning of several thousand of their children would care about your children.
TomDVM - I am positive that they do not care about my child. That’s why I choose to keep fighting this.
Monotreme - That is really wierd about how the mix came to be. This article is so loaded with information that is dependent on sequences for further detail. I am curious about the article being submitted as a correspondence and not a full blown article. Was it to rush the info out or to deliberately keep it short?
Monotreme - or do a correspondence to avoid the sequence list. You know how these things work. What do you think?
Monotreme - or do a correspondence to avoid the sequence release. You know how these things work. What do you think?
Tom DVM, Yes, we all have to make clear that we are bashing the Chinese government and not the Chinese people. Sometimes we say “China this” or “China that” and in our minds we mean the government but overseas Chinese might think we mean the Chinese people. It doesn’t hurt to clarify ourselves every once in a while.
I am still haunted by Qinghai. We don’t know whether the Boxun reports are true, but if so we can only guess at the horrors the people there have endured. And what they will have to endure in the future.
Nightowl, everything about that paper is weird. I can’t imagine a reviewer reading that paper and not insisting on seeing the sequences. You can’t properly judge their figures without access to the sequences. In a scientific paper you are obliged to provide all the data necessary for another scientist to repeat your findings. Their findings were the phylogenetics analyses. Well, there is no way another scientist can repeat that analysis without the sequences. So, publishing the paper without the sequences violates two priniciples of science:
1. The reviewers need adequate information to judge the value of paper.
2. The readers need adequate information to repeat the analyses.
It’s pretty hard to guess the motives of the authors, but the Editors of the NEJM really should explain their motives in publishing this paper without the requiring deposit of the sequences.
it is possible to show phylo-trees without the sequences. You could even get it approved by a confident but reliable notary or such. And both could just be wrong,constructed,lies. No guarantee that a submitted sequence is correct.
Unfortunately the Chinese Government doesn’t a couple of credo’s
Do unto others as you would have them do unto you.
What goes around, comes around.
Monotreme you can bet that Qinghai was true…a little reinforcement for Tianamen.
The bottome lin for me in 1998 was that in my wildest dreams, I never thought anyone would be stupid enough or malicious enough to use formaldehyde (embalming fluid) as a food preservative…let alone the concentrations that they achieved…
…they demonstrated to me very clearly that they had complete disdain for their fellow travellers on this planet and particularly children…
…therefore I have zero respect for them.
I have great sympathy for the persons who are enslaved to these .
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