In any infectious outbreak, one of the first steps in the epidemiological response is to locate case one—the first infected patient, also known as the index case or patient zero. This is not a mere clinical curiosity: it is the foundation for reconstructing the chain of transmission.
Modern epidemiology treats this process as a technical priority. As stated in the Dictionary of Epidemiology by the International Epidemiological Association, identifying patient zero is essential to understanding patterns of dissemination and establishing effective control strategies.
Yet in the case of SARS-CoV-2—the virus that unleashed a global pandemic between late 2019 and early 2020—no independent or transparent international investigation was ever conducted to clearly identify where, how, and with whom it all began. The city of Wuhan, China, is widely acknowledged as the epicenter of the earliest cases, but no international health authority was granted free access to clinical records, sample banks, or laboratory data.
This refusal to apply the basic principles of epidemiological inquiry raises a question that is as much technical as it is political: why was the origin of the virus not investigated with the same rigor applied to other pandemics?
Wuhan, the Lab, and What Remains Unknown
Wuhan—the capital of China’s Hubei province—is home to the Wuhan Institute of Virology (WIV), one of the world’s leading centers for research on animal-origin coronaviruses. Even before the pandemic, the WIV had been conducting experiments with bat viruses, including gain-of-function techniques—genetic manipulations designed to increase viral infectivity in model organisms, such as humanized mice or cell cultures.
In 2015, an international study involving the WIV and American researchers, published in Nature Medicine, drew attention for creating a chimeric bat virus capable of infecting human cells, sparking debates about scientific risks and bioethics.
When the outbreak emerged in December 2019, several anomalies immediately stood out:
- The virus’s initial strain already had high affinity for the human ACE2 receptor;
- No intermediate animal host was identified;
- Biological samples and patient data disappeared or became inaccessible
Still, the World Health Organization (WHO) only organized a supervised visit to the WIV in January 2021. The final report—drafted in cooperation with Chinese authorities—dismissed the lab-leak hypothesis as “extremely unlikely,” although WHO Director-General Tedros Adhanom Ghebreyesus later acknowledged that “all hypotheses remain on the table.”
It’s worth noting that Tedros is not a physician, but a biologist. He served as Ethiopia’s Minister of Health and Foreign Affairs during the rule of the Ethiopian People’s Revolutionary Democratic Front (EPRDF), an authoritarian regime. According to reports by the New York Times and The Telegraph, Tedros was accused of covering up cholera outbreaks by labeling them as “acute watery diarrhea”—hiding them from the international community.
During his tenure, he was accused by NGOs and global news outlets of officially reclassifying cholera outbreaks to avoid tarnishing the regime’s international image—allegations supported by regional health workers and UN specialists. The Telegraph also reported that the outbreaks were deliberately underreported and renamed under his watch.
Furthermore, the EPRDF has been widely criticized for suppressing dissent, curtailing civil liberties, and systematically censoring political opposition and the independent press.
Although these issues do not technically invalidate Tedros’s current role, they raise legitimate concerns about the institutional trustworthiness of international authorities emerging from opaque regimes. When a WHO director with such a background becomes the leading global voice during a pandemic, it becomes all the more urgent to demand open, verifiable investigations conducted by truly independent teams—something that, in the case of SARS-CoV-2, has never effectively occurred.
Medicine without Etiology: The Clinical Paradox
Modern medicine is, above all, a science of causes. Since Hippocrates, it has been understood that treating a disease requires understanding its origin—biological, environmental, or epidemiological. Clinical practice, microbiology, infectious diseases, and public health share this principle: without etiology, there is no complete diagnosis; without diagnosis, there is no prevention or lasting cure.
In epidemiology, identifying case one—the first infected patient, also called the index case—is essential for containing outbreaks and tracing transmission routes. Cases like Ebola in West Africa in 2014 or SARS-CoV-1 in 2002 demonstrated how tracing the origin enabled effective, evidence-based health responses.
However, with SARS-CoV-2, this logic was reversed. Instead of rigorously investigating the outbreak’s origin in Wuhan, international institutions chose to manage the pandemic as if the origin were irrelevant. There was no access to raw data, initial clinical samples, or the genetic database of the Wuhan Institute of Virology. Medicine began treating the global symptom while ignoring the local lesion.
This break in clinical logic created a troubling paradox:
- Physicians and scientists were called upon to prescribe mass solutions without knowing the etiological agent in its initial form;
- Global protocols were implemented without understanding the primary cycle of infection;
- Public policies were based on statistical models disconnected from the real origin of the phenomenon.
The absence of case one deprived medicine of its rational foundation. Epidemiology ceased to be causal tracing and became diffuse containment, supported by abstract projections and the morality of fear. Never were so many authoritarian measures applied with so little information about the outbreak’s beginning. Never was so much obedience demanded with so little reliable knowledge about the origin of the risk.
Medicine was separated from its etiology—and by being instrumentalized by political decisions, it risked losing its autonomy, its ethics, and its public trust.
The Logic of Fear and the Morality of Ignorance
The SARS-CoV-2 pandemic revealed a disturbing phenomenon: the transformation of fear into a criterion of truth. In the face of uncertainty, institutional collapse, and fragile health systems, a silent consensus emerged—it was not time to ask questions, but to obey.
Legitimate inquiries into the virus’s origin became frowned upon. Questioning the conduct of the World Health Organization or suggesting that the outbreak might have started in a laboratory in Wuhan was promptly labeled a “conspiracy theory.” What was once healthy skepticism came to be treated as a moral deviation.
This process resembles what economist and philosopher Thomas Sowell called the “morality of intentions”: in times of crisis, people tend to judge actions by the fear they experience, not by the available evidence. Thus, ignorance ceased to be a limitation to be overcome and became an institutionally accepted—and even desired—state.
This new model of moral ignorance was structured on three levels:
- Governmental: governments avoided deepening investigations that might compromise strategic allies or expose internal failures;
- Scientific: researchers self-censored hypotheses for fear of institutional retaliation or loss of funding;
- Social: the frightened population began to prefer official certainties—even if empty—over the complexity of the unknown.
This attitude is philosophically analogous to what Martin Heidegger called inauthenticity: fleeing from responsibility in the face of the anguish of reality, replaced by uncritical adherence to the dominant discourse. Ironically, Heidegger himself supported Nazism in its early days—a reminder that the denial of critical thinking often accompanies authoritarian projects disguised as common good.
During the pandemic, we witnessed the emergence of a new epistemology: the epistemology of obedience. According to writer Jeffrey Tucker, this obedience is sold as a virtue—“trust the science,” “follow the authority,” “don’t question the WHO.” But science without doubt is not science. Authority that refuses to be questioned ceases to be legitimate—it becomes dogma.
Economist Jesús Huerta de Soto goes further: he warns that the state monopoly on science is not only ineffective—it is anti-scientific by nature. When knowledge is subjected to political commands, it becomes a tool of power, not of discovery. This critique resonates with the work of the Instituto Mises Brasil, which—from the beginning of the crisis—denounced the erosion of civil liberties and the use of scientific authority as a tool of state control disguised as health care. As Hélio Beltrão—president of the IMB—stated in a 2021 article:
The problem is not the virus itself, but the political response to the virus. The hysteria, fueled by authorities and the media, opened the door to authoritarianism disguised as compassion.
The silence about SARS-CoV-2’s case one, then, was not merely a technical error or political omission; it was an ethical and epistemological choice: to accept not knowing, in order not to have to assume responsibility.
Conclusion: The Virus That Was Born an Orphan
SARS-CoV-2—contrary to the logic of epidemiology—had no officially-recognized father, mother, or cradle. It emerged, killed, and was fought with every technical and political resource—yet its origin was never investigated in an open, independent, and accountable manner. This omission was not due to ignorance, but to an institutional architecture that favors control over truth.
The pandemic was not just a biological or technical challenge. It was an epistemological crisis in which fear was promoted as virtue, ignorance as protection, and authority as dogma. The search for case one was abandoned not because it was irrelevant, but because it threatened to hold accountable those who could not be held accountable.
As Ludwig von Mises taught, truth does not belong to the state, nor to the majority, nor to the experts; it belongs to reason. If reason was silenced during the greatest health crisis of the century, the task of restoring it now falls to those who reject the comfort of obedience in favor of the duty of lucidity. Freedom, after all, does not begin where everything is known—but where everything can be asked.
