It also seems The Lancet letter doesn't actual address the question of lab leak. Only that it wasn't engineered. That was a pretty hot conspiracy theory at the time and one that remains far fetched. They didn't positively say it couldn't be a naturally occurring virus that leaked. I don't know enough to comment on gain of function leaves any hallmarks but I'm guessing it doesn't since it tries to replicate evolution.
Medical practices and norms vary widely depending on the culture you live in.
there's numerous posts in previous discussions saying that in China people do, because they don't typically have a GP and so go to the hospital for any acute ailment.
The “engineered” comments refer to common amino acid sequences from lab practices, they leave a signature because ordinary biology is more random.
The gene sequence for the amino acids in the furin site in CoV-2 uses a very rare set of two codons, three letter words so six letters in a row, that arerarely used individually and have never been seen together in tandem in any coronaviruses in nature. But these same ‘rare in nature’ codons turn out to be the very ones that are always used by scientists in the laboratory when researchers want to add the amino acid arginine, the ones that are found in the furin site. When scientists add a dimer of arginine codons to a coronavirus, they invariably use the word, CGG-CGG, but coronaviruses in nature rarely (<1%) use this codon pair. For example, in the 580,000 codons of 58 Sarbecoviruses the only CGG pair is CoV-2; none of the other 57 sarbecoviruses have such a pair.https://twitter.com/K_G_Andersen/status/1391507272887455746
Basically, it's somewhat rare but not wildly so. FCoV has an RR pair, the first is coded as CGG, and the second as CGA, a difference of one base pair.
Developed chimeric SARS-like coronaviruses
Conducted ’dangerous’ gain-of-function research on the SARS-CoV-1 virus, some of which had been funded by the US government (Asia Times)
Established a 96.2% match with SARS-CoV-2 and a virus they sampled from a cave over 1,000 miles away from Wuhan
Injected live piglets with bat coronaviruses as recently as July 2019
Published a paper on a close descendant of SARS-CoV-1, MERS-CoV, in November 2019
Was hiring researchers to work on bat coronaviruses as recently as November 2019
You have to imagine the very real possibility that it was just an accident.