A big part of what the researcher discusses is how China had developed a mechanism for detecting "Viral Pneumonia of Unknown Etiology" (VPUE) after the previous SARS outbreak, pointing out that it only partially succeeded here (mostly failed), and he is trying to start a conversation on how to improve that system in China and elsewhere in the world.
Although a widely cited report (7) credits the VPUE mechanism with uncovering the pandemic, it was HPHICWM that identified both the outbreak and the Huanan Market connection and passed on these fully formed discoveries to district, municipal, and provincial public health officials by 29 December (9). National officials reportedly did not learn about the outbreak until CCDC Director George Gao encountered online group chats about the WHC emergency notices on the evening of 30 December. Concerned that so many cases had not been reported to the VPUE system, he quickly notified the National Health Commission (14) (see fig. S1).
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Although mechanisms like China’s VPUE system are potentially invaluable, they will fail without both widespread buy-in from health care providers and rapid data sharing from local to central authorities. Key problems with the VPUE system were known before the pandemic, including that most clinicians in China had little awareness of the VPUE system and were not reporting cases to it—for example, 0 of 335 PUE cases in one study from 2019 (5). China should be commended, however, for having such a system, which is lacking in most countries. The focus now should be on fixing the problems that COVID-19 has exposed and blanketing the globe with a highly functional PUE early warning system.
So, irrespective of whether a contaminated researcher from the virology institute wandered into the market, or the contamination came from live animals within the market, his major conclusion is that community spread was already occurring in the middle of December centered on the market with the first real human (asymptomatic) infection likely occurring about November 18.
That's a lot of useful information to be aware of now and going forward in anticipation of the "next virus with this pattern of spread".
