A strategy to prevent future epidemics similar to the 2019-nCoV outbreak

A sensitive and simple RT-LAMP assay for sarbecovirus screening in bats

IMPORTANCE

We report the application of a colorimetric and fluorescent reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay to facilitate mass screening for sarbecoviruses in bats. The assay was evaluated using a total of 838 oral and alimentary samples from bats and demonstrated comparable sensitivity and specificity to quantitative reverse transcription PCR (qRT-PCR), with a simple setup. The addition of SYTO9, a fluorescent nucleic acid stain, also allows for quantitative analysis. The scalability and simplicity of the assay are believed to contribute to improving preparedness for detecting emerging coronaviruses by applying it to field studies and surveillance.

Strengthening coordination and collaboration of one health approach for zoonotic diseases in Africa

Despite the One Health progress made in some African countries in addressing zoonotic disease outbreaks, many still lack formal and funded One Health programs. Countries lack diagnostic capacity for zoonotic diseases, coordinated surveillance mechanisms, multisectoral response strategies and skilled workforce. With the devasting impacts of zoonotic disease outbreaks, recent epidemics have caused a loss of lives and negatively impacted the economy. Strengthening One Health approach across African Union (AU) Member States will improve the continent's ability and capacity to efficiently prevent, detect, and respond to emerging and re-emerging zoonotic diseases. The policy and practice changes needed to address zoonotic diseases require strong political commitment, financial investments, and institutionalised national One Health programs. The African Union endorses a One Health approach in which multiple sectors work jointly to raise awareness, gather credible data, implement programs, and promote evidence-based policy and practice in improve human, animal, and environmental health. The African Union working through its technical agencies set up an interagency multidisciplinary group "the One Health Coordinating Group on Zoonotic Diseases" to strengthen coordinated surveillance, prevention and control of zoonotic diseases on the continent. There is an urgent need to strengthen the coordination of One Health activities across the African continent. The African Union will leverage its unique political position on the continent to raise awareness, secure commitments, and influence policy at the head of state level. This manuscript highlights the opportunity to improve and strengthen One Health coordination and harmonisation of efforts through a continental strategy for zoonotic disease control.

Perceptions of COVID-19 origins and China's wildlife policy reforms

Given the link between perceptions of zoonotic risk and support for regulations such as wildlife consumption bans, debates regarding the origins of COVID-19 are likely to have conservation implications. Specifically, alternative hypotheses that cast doubt on COVID-19's zoonotic origins could potentially lessen momentum for China's wildlife policy reforms and their associated conservation impacts. To better understand the impact of COVID-19 origin debates on China's wildlife policies, we conducted a 974-respondent survey across mainland China, supplemented by policy and media reviews. We examined perceptions of three facets of COVID-19 origins: geographic location, source (e.g., wildlife farm, wet market, etc.), and specific wildlife species as transmitters. Our findings reveal that 64.6 % of respondents believed COVID-19 originated in the United States or Europe, not in China. Further, compared to the baseline group of respondents who selected China as the origin country, respondents who selected the United States or Europe as the origin had a greater likelihood of selecting laboratories/research and imported frozen foods as likely sources, while these respondents had a lower likelihood of selecting wild animals in a wet market or natural causes as likely sources. Despite such varied beliefs regarding COVID-19 origins, support for wildlife policy reforms was strong: 89.5 % of respondents who previously consumed wildlife self-indicated reduced consumption after the pandemic and 70.5 % of respondents supported banning the trade of all wildlife species. Moreover, those respondents who selected wild animals in a wet market as a likely source of COVID-19 had a greater likelihood of supporting a trade ban on all wild-caught wildlife and all farmed wildlife. Our results indicate that, although investigation of COVID-19's origins is on-going and politicized, there is clear support for wildlife reforms in China that can promote conservation outcomes.

Global governance for pandemic prevention and the wildlife trade

Although ideas about preventive actions for pandemics have been advanced during the COVID-19 crisis, there has been little consideration for how they can be operationalised through governance structures within the context of the wildlife trade for human consumption. To date, pandemic governance has mostly focused on outbreak surveillance, containment, and response rather than on avoiding zoonotic spillovers in the first place. However, given the acceleration of globalisation, a paradigm shift towards prevention of zoonotic spillovers is warranted as containment of outbreaks becomes unfeasible. Here, we consider the current institutional landscape for pandemic prevention in light of ongoing negotiations of a so-called pandemic treaty and how prevention of zoonotic spillovers from the wildlife trade for human consumption could be incorporated. We argue that such an institutional arrangement should be explicit about zoonotic spillover prevention and focus on improving coordination across four policy domains, namely public health, biodiversity conservation, food security, and trade. We posit that this pandemic treaty should include four interacting goals in relation to prevention of zoonotic spillovers from the wildlife trade for human consumption: risk understanding, risk assessment, risk reduction, and enabling funding. Despite the need to keep political attention on addressing the current pandemic, society cannot afford to miss the opportunity of the current crisis to encourage institution building for preventing future pandemics.

Addressing Complexity in the Pandemic Context: How Systems Thinking Can Facilitate Understanding of Design Aspects for Preventive Technologies

The COVID-19 pandemic constitutes a wicked problem that is defined by rapidly evolving and dynamic conditions, where the physical world changes (e.g., pathogens mutate) and, in parallel, our understanding and knowledge rapidly progress. Various preventive measures have been developed or proposed to manage the situation, including digital preventive technologies to support contact tracing or physical distancing. The complexity of the pandemic and the rapidly evolving nature of the situation pose challenges for the design of effective preventive technologies. The aim of this conceptual paper is to apply a systems thinking model, DSRP (distinctions, systems, relations, perspectives) to explain the underlying assumptions, patterns, and connections of the pandemic domain, as well as to identify potential leverage points for design of preventive technologies. Two different design approaches, contact tracing and nudging for distance, are compared, focusing on how their design and preventive logic are related to system complexity. The analysis explains why a contact tracing technology involves more complexity, which can challenge both implementation and user understanding. A system utilizing nudges can operate using a more distinct system boundary, which can benefit understanding and implementation. However, frequent nudges might pose challenges for user experience. This further implies that these technologies have different contextual requirements and are useful at different levels in society. The main contribution of this work is to show how systems thinking can organize our understanding and guide the design of preventive technologies in the context of epidemics and pandemics.

From FAIR to FAIRS: Data security by design for the global burden of animal diseases

Solving complex global problems involving data and data analysis can require data from both the public and private sectors. The sharing of data has traditionally been restricted to open data. To facilitate the use of both open and private data, a new data-sharing framework has been constructed as an extension to the popular Findable-Accessible-Interoperable-Reusable (FAIR) framework. The "Secure by Design" approach has been taken to define the FAIRS data-sharing framework where S stands for Secure. A Cloud infrastructure architecture is proposed that would allow data brokers to implement FAIRS. This architecture is being constructed for the Global Burden of Animal Diseases (GBADs) to facilitate the sharing of livestock data.

Meta-analysis to explain unknown causes of the origins of SARS-COV-2

New Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes the Coronavirus Disease 2019 (COVID-19), an infectious illness that has generated a pandemic crisis worldwide. One of the fundamental questions in science and society is how SARS-CoV-2 has been originated to design best practices directed to prevent and/or to cope with future hazardous pathogens. The study confronts this question here developing a meta-analysis, which endeavors to explain, whenever possible, unknown sources of the SARS-CoV-2. Findings suggest that the natural spillover of novel viral agents that generate more than 6.00 M deaths worldwide in about two years (such as, SARS-CoV-2 from February 2020 to March 2022) has a remote probability of occurrence (using an analogy with the probability of natural disasters generating a lot of fatalities), whereas science advances on hazardous viral agents and consequential lab accident have a (higher) probability of occurrence (about 13-20% like in manifold lab accidents). The findings of this meta-analysis suggest the vital role of improving the technical guidelines of biosafety at all levels in laboratories during the development of scientific research of experimental virology on hazardous pathogens to minimize risks of pandemic threats in environment and human society.

Surveillance of emerging infectious diseases for biosecurity

Emerging infectious diseases, such as COVID-19, continue to pose significant threats to human beings and their surroundings. In addition, biological warfare, bioterrorism, biological accidents, and harmful consequences arising from dual-use biotechnology also pose a challenge for global biosecurity. Improving the early surveillance capabilities is necessary for building a common biosecurity shield for the global community of health for all. Furthermore, surveillance could provide early warning and situational awareness of biosecurity risks. However, current surveillance systems face enormous challenges, including technical shortages, fragmented management, and limited international cooperation. Detecting emerging biological risks caused by unknown or novel pathogens is of particular concern. Surveillance systems must be enhanced to effectively mitigate biosecurity risks. Thus, a global strategy of meaningful cooperation based on efficient integration of surveillance at all levels, including interdisciplinary integration of techniques and interdepartmental integration for effective management, is urgently needed. In this paper, we review the biosecurity risks by analyzing potential factors at all levels globally. In addition to describing biosecurity risks and their impact on global security, we also focus on analyzing the challenges to traditional surveillance and propose suggestions on how to integrate current technologies and resources to conduct effective global surveillance.

Fc engineered ACE2-Fc is a potent multifunctional agent targeting SARS-CoV2

Joining a function-enhanced Fc-portion of human IgG to the SARS-CoV-2 entry receptor ACE2 produces an antiviral decoy with strain transcending virus neutralizing activity. SARS-CoV-2 neutralization and Fc-effector functions of ACE2-Fc decoy proteins, formatted with or without the ACE2 collectrin domain, were optimized by Fc-modification. The different Fc-modifications resulted in distinct effects on neutralization and effector functions. H429Y, a point mutation outside the binding sites for FcγRs or complement caused non-covalent oligomerization of the ACE2-Fc decoy proteins, abrogated FcγR interaction and enhanced SARS-CoV-2 neutralization. Another Fc mutation, H429F did not improve virus neutralization but resulted in increased C5b-C9 fixation and transformed ACE2-Fc to a potent mediator of complement-dependent cytotoxicity (CDC) against SARS-CoV-2 spike (S) expressing cells. Furthermore, modification of the Fc-glycan enhanced cell activation via FcγRIIIa. These different immune profiles demonstrate the capacity of Fc-based agents to be engineered to optimize different mechanisms of protection for SARS-CoV-2 and potentially other viral pathogens.

Human-Altered Landscapes and Climate to Predict Human Infectious Disease Hotspots

Background: Zoonotic diseases account for more than 70% of emerging infectious diseases (EIDs). Due to their increasing incidence and impact on global health and the economy, the emergence of zoonoses is a major public health challenge. Here, we use a biogeographic approach to predict future hotspots and determine the factors influencing disease emergence. We have focused on the following three viral disease groups of concern: Filoviridae, Coronaviridae, and Henipaviruses. Methods: We modelled presence–absence data in spatially explicit binomial and zero-inflation binomial logistic regressions with and without autoregression. Presence data were extracted from published studies for the three EID groups. Various environmental and demographical rasters were used to explain the distribution of the EIDs. True Skill Statistic and deviance parameters were used to compare the accuracy of the different models. Results: For each group of viruses, we were able to identify and map areas at high risk of disease emergence based on the spatial distribution of the disease reservoirs and hosts of the three viral groups. Common influencing factors of disease emergence were climatic covariates (minimum temperature and rainfall) and human-induced land modifications. Conclusions: Using topographical, climatic, and previous disease outbreak reports, we can identify and predict future high-risk areas for disease emergence and their specific underlying human and environmental drivers. We suggest that such a predictive approach to EIDs should be carefully considered in the development of active surveillance systems for pathogen emergence and epidemics at local and global scales.

Serology as a Tool to Assess Infectious Disease Landscapes and Guide Public Health Policy

Understanding the local burden and epidemiology of infectious diseases is crucial to guide public health policy and prioritize interventions. Typically, infectious disease surveillance relies on capturing clinical cases within a healthcare system, classifying cases by etiology and enumerating cases over a period of time. Disease burden is often then extrapolated to the general population. Serology (i.e., examining serum for the presence of pathogen-specific antibodies) has long been used to inform about individuals past exposure and immunity to specific pathogens. However, it has been underutilized as a tool to evaluate the infectious disease burden landscape at the population level and guide public health decisions. In this review, we outline how serology provides a powerful tool to complement case-based surveillance for determining disease burden and epidemiology of infectious diseases, highlighting its benefits and limitations. We describe the current serology-based technologies and illustrate their use with examples from both the pre- and post- COVID-19-pandemic context. In particular, we review the challenges to and opportunities in implementing serological surveillance in low- and middle-income countries (LMICs), which bear the brunt of the global infectious disease burden. Finally, we discuss the relevance of serology data for public health decision-making and describe scenarios in which this data could be used, either independently or in conjunction with case-based surveillance. We conclude that public health systems would greatly benefit from the inclusion of serology to supplement and strengthen existing case-based infectious disease surveillance strategies.

Identification of Coronaviruses in Farmed Wild Animals Reveals their Evolutionary Origins in Guangdong, Southern China

Coronavirus infections cause diseases that range from mild to severe in mammals and birds. In this study, we detected coronavirus infections in 748 farmed wild animals of 23 species in Guangdong, southern China, by RT-PCR and metagenomic analysis. We identified four coronaviruses in these wild animals and analysed their evolutionary origins. Coronaviruses detected in Rhizomys sinensis were genetically grouped into canine and rodent coronaviruses, which were likely recombinants of canine and rodent coronaviruses. The coronavirus found in Phasianus colchicus was a recombinant pheasant coronavirus of turkey coronavirus and infectious bronchitis virus. The coronavirus in Paguma larvata had a high nucleotide identity (94.6–98.5 per cent) with a coronavirus of bottlenose dolphin (Tursiops truncates). These findings suggested that the wildlife coronaviruses may have experienced homologous recombination and/or crossed the species barrier, likely resulting in the emergence of new coronaviruses. It is necessary to reduce human–animal interactions by prohibiting the eating and raising of wild animals, which may contribute to preventing the emergence of the next coronavirus pandemic.

Microbial ecology and evolution is key to pandemics: using the coronavirus model to mitigate future public health challenges

Pandemics are global challenges that lead to total disruption of human activities. From the inception of human existence, all pandemics have resulted in loss of human lives. The coronavirus disease caused by SAR-CoV-2 began in China and is now at the global scale with an increase in mortality and morbidity. Numerous anthropogenic activities have been implicated in the emergence and severity of pandemics, including COVID-19. These activities cause changes in microbial ecology, leading to evolution due to mutation and recombination. This review hypothesized that an understanding of these anthropogenic activities would explain the dynamics of pandemics. The recent coronavirus model was used to study issues leading to microbial evolution, towards preventing future pandemics. Our review highlighted anthropogenic activities, including deforestation, mining activities, waste treatment, burning of fossil fuel, as well as international travels as drivers of microbial evolution leading to pandemics. Furthermore, human-animal interaction has also been implicated in pandemic incidents. Our study recommends substantial control of such anthropogenic activities as having been highlighted as ways to reduce the frequency of mutation, reduce pathogenic reservoirs, and the emergence of infectious diseases.

Averting wildlife-borne infectious disease epidemics requires a focus on socio-ecological drivers and a redesign of the global food system

A debate has emerged over the potential socio-ecological drivers of wildlife-origin zoonotic disease outbreaks and emerging infectious disease (EID) events. This Review explores the extent to which the incidence of wildlife-origin infectious disease outbreaks, which are likely to include devastating pandemics like HIV/AIDS and COVID-19, may be linked to excessive and increasing rates of tropical deforestation for agricultural food production and wild meat hunting and trade, which are further related to contemporary ecological crises such as global warming and mass species extinction. Here we explore a set of precautionary responses to wildlife-origin zoonosis threat, including: (a) limiting human encroachment into tropical wildlands by promoting a global transition to diets low in livestock source foods; (b) containing tropical wild meat hunting and trade by curbing urban wild meat demand, while securing access for indigenous people and local communities in remote subsistence areas; and (c) improving biosecurity and other strategies to break zoonosis transmission pathways at the wildlife-human interface and along animal source food supply chains.

Ecology, evolution and spillover of coronaviruses from bats

In the past two decades, three coronaviruses with ancestral origins in bats have emerged and caused widespread outbreaks in humans, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first SARS epidemic in 2002-2003, the appreciation of bats as key hosts of zoonotic coronaviruses has advanced rapidly. More than 4,000 coronavirus sequences from 14 bat families have been identified, yet the true diversity of bat coronaviruses is probably much greater. Given that bats are the likely evolutionary source for several human coronaviruses, including strains that cause mild upper respiratory tract disease, their role in historic and future pandemics requires ongoing investigation. We review and integrate information on bat-coronavirus interactions at the molecular, tissue, host and population levels. We identify critical gaps in knowledge of bat coronaviruses, which relate to spillover and pandemic risk, including the pathways to zoonotic spillover, the infection dynamics within bat reservoir hosts, the role of prior adaptation in intermediate hosts for zoonotic transmission and the viral genotypes or traits that predict zoonotic capacity and pandemic potential. Filling these knowledge gaps may help prevent the next pandemic.

Leveraging community science data for population assessments during a pandemic

The COVID-19 pandemic has disrupted field research programs, making conservation and management decision-making more challenging. However, it may be possible to conduct population assessments using integrated models that combine community science data with existing data from structured surveys. We developed a space-time integrated model to characterize spatial and temporal variability in population distribution. We fit our integrated model to 10 years of eBird (2010-2020) and 9 years of aerial survey (2010-2019) Mottled Duck count data to forecast 2020 population size along the western Gulf Coast of Texas and Louisiana. Estimates of Mottled Duck abundance were similar in magnitude to estimates calculated using previous methods but were more precise and showed evidence of a declining population. The spatial distribution for Mottled Ducks each year was characterized by several concentrations of relatively high abundance, although the location of these abundance "hotspots" varied over time. Expected abundance was higher for areas with a higher proportion of area covered by marsh habitat. By leveraging large-scale community science data, we were able to conduct a population assessment despite the disruption in structured surveys caused by the pandemic. As participation in community science platforms continues to increase, we anticipate modeling frameworks, like the integrated model we developed here, will become increasingly useful for informing conservation and management decision-making.

The "One Health" approach in the face of Covid-19: how radical should it be?

BACKGROUND

The 2020-2021 coronavirus (Covid-19) pandemic is just the latest epidemic event that requires us to rethink and change our understanding of health. Health should no longer be conceived only in relation to human beings, but in unitary terms, as a dimension that connects humans, animals, plants, and the environment (holistic view, One Health). In general, alterations occurring in this articulated chain of life trigger a domino effect.

METHODOLOGY

In this paper, we review the One Health paradigm in the light of the Covid-19 pandemic and distinguish two approaches within it that might be dubbed the Prudent one and the Radical one. Each approach is structured in three levels - epistemological, medical, and ethical.

RESULTS

In this way, we show how we humans can better address the pandemic today and how, in the future, we can treat the whole living system better, by renouncing our anthropocentric perspective on health.

CONCLUSION

We hold that the Prudent approach can be very helpful, and we discuss the medical and ethical issues related to it. We also consider the Radical view and the epistemological turn it requires compared to the Prudent one.

The costs and benefits of primary prevention of zoonotic pandemics

The lives lost and economic costs of viral zoonotic pandemics have steadily increased over the past century. Prominent policymakers have promoted plans that argue the best ways to address future pandemic catastrophes should entail, "detecting and containing emerging zoonotic threats." In other words, we should take actions only after humans get sick. We sharply disagree. Humans have extensive contact with wildlife known to harbor vast numbers of viruses, many of which have not yet spilled into humans. We compute the annualized damages from emerging viral zoonoses. We explore three practical actions to minimize the impact of future pandemics: better surveillance of pathogen spillover and development of global databases of virus genomics and serology, better management of wildlife trade, and substantial reduction of deforestation. We find that these primary pandemic prevention actions cost less than 1/20th the value of lives lost each year to emerging viral zoonoses and have substantial cobenefits.

Food security and emerging infectious disease: risk assessment and risk management

Climate change, emerging infectious diseases (EIDs) and food security create a dangerous nexus. Habitat interfaces, assumed to be efficient buffers, are being disrupted by human activities which in turn accelerate the movement of pathogens. EIDs threaten directly and indirectly availability and access to nutritious food, affecting global security and human health. In the next 70 years, food-secure and food-insecure countries will face EIDs driving increasingly unsustainable costs of production, predicted to exceed national and global gross domestic products. Our modern challenge is to transform this business as usual and embrace an alternative vision of the biosphere formalized in the Stockholm paradigm (SP). First, a pathogen-centric focus shifts our vision of risk space, determining how pathogens circulate in realized and potential fitness space. Risk space and pathogen exchange are always heightened at habitat interfaces. Second, apply the document-assess-monitor-act (DAMA) protocol developing strategic data for EID risk, to be translated, synthesized and broadcast as actionable information. Risk management is realized through targeted interventions focused around information exchanged among a community of scientists, policy practitioners of food and public health security and local populations. Ultimately, SP and DAMA protect human rights, supporting food security, access to nutritious food, health interventions and environmental integrity.

Best Molecular Tools to Investigate Coronavirus Diversity in Mammals: A Comparison

Coronaviruses (CoVs) are widespread and highly diversified in wildlife and domestic mammals and can emerge as zoonotic or epizootic pathogens and consequently host shift from these reservoirs, highlighting the importance of veterinary surveillance. All genera can be found in mammals, with α and β showing the highest frequency and diversification. The aims of this study were to review the literature for features of CoV surveillance in animals, to test widely used molecular protocols, and to identify the most effective one in terms of spectrum and sensitivity. We combined a literature review with analyses in silico and in vitro using viral strains and archive field samples. We found that most protocols defined as pan-coronavirus are strongly biased towards α- and β-CoVs and show medium-low sensitivity. The best results were observed using our new protocol, showing LoD 100 PFU/mL for SARS-CoV-2, 50 TCID₅₀/mL for CaCoV, 0.39 TCID₅₀/mL for BoCoV, and 9 ± 1 log2 ×10⁻⁵ HA for IBV. The protocol successfully confirmed the positivity for a broad range of CoVs in 30/30 field samples. Our study points out that pan-CoV surveillance in mammals could be strongly improved in sensitivity and spectrum and propose the application of a new RT-PCR assay, which is able to detect CoVs from all four genera, with an optimal sensitivity for α-, β-, and γ-.

Tetravalent SARS-CoV-2 Neutralizing Antibodies Show Enhanced Potency and Resistance to Escape Mutations

Neutralizing antibodies (nAbs) hold promise as therapeutics against COVID-19. Here, we describe protein engineering and modular design principles that have led to the development of synthetic bivalent and tetravalent nAbs against SARS-CoV-2. The best nAb targets the host receptor binding site of the viral S-protein and tetravalent versions block entry with a potency exceeding bivalent nAbs by an order of magnitude. Structural studies show that both the bivalent and tetravalent nAbs can make multivalent interactions with a single S-protein trimer, consistent with the avidity and potency of these molecules. Significantly, we show that the tetravalent nAbs show increased tolerance to potential virus escape mutants and an emerging variant of concern. Bivalent and tetravalent nAbs can be produced at large-scale and are as stable and specific as approved antibody drugs. Our results provide a general framework for enhancing antiviral therapies against COVID-19 and related viral threats, and our strategy can be applied to virtually any antibody drug.

The Invasive Bank Vole (Myodes glareolus): A Model System for Studying Parasites and Ecoimmunology during a Biological Invasion

The primary driver of the observed increase in emerging infectious diseases (EIDs) has been identified as human interaction with wildlife and this increase has emphasized knowledge gaps in wildlife pathogens dynamics. Wild rodent models have proven excellent for studying changes in parasite communities and have been a particular focus of eco-immunological research. Helminth species have been shown to be one of the factors regulating rodent abundance and indirectly affect disease burden through trade-offs between immune pathways. The Myodes glareolus invasion in Ireland is a unique model system to explore the invasion dynamics of helminth species. Studies of the invasive population of M. glareolus in Ireland have revealed a verifiable introduction point and its steady spread. Helminths studies of this invasion have identified enemy release, spillover, spillback and dilution taking place. Longitudinal studies have the potential to demonstrate the interplay between helminth parasite dynamics and both immune adaptation and coinfecting microparasites as M. glareolus become established across Ireland. Using the M. glareolus invasion as a model system and other similar wildlife systems, we can begin to fill the large gap in our knowledge surrounding the area of wildlife pathogen dynamics.

Coronavirus disease 2019 and its potential animal reservoirs: A review

In the 21st century, the world has been plagued by coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus of the family Coronaviridae epidemiologically suspected to be linked to a wet market in Wuhan, China. The involvement of wildlife and wet markets with the previous outbreaks simultaneously has been brought into sharp focus. Although scientists are yet to ascertain the host range and zoonotic potential of SARS-CoV-2 rigorously, information about its two ancestors, SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), is a footprint for research on COVID-19. A 96% genetic similarity with bat coronaviruses and SARS-CoV-2 indicates that the bat might be a potential reservoir of SARS-CoV-2 just like SARS-CoV and MERS-CoV, where civets and dromedary camels are considered the potential intermediate host, respectively. Perceiving the genetic similarity between pangolin coronavirus and SARS-CoV-2, many scientists also have given the scheme that the pangolin might be the intermediate host. The involvement of SARS-CoV-2 with other animals, such as mink, snake, and turtle has also been highlighted in different research articles based on the interaction between the key amino acids of S protein in the receptor-binding domain and angiotensin-converting enzyme II (ACE2). This study highlights the potential animal reservoirs of SARS-CoV-2 and the role of wildlife in the COVID-19 pandemic. Although different causes, such as recurring viral genome recombination, wide genetic assortment, and irksome food habits, have been blamed for this emergence, basic research studies and literature reviews indicate an enormous consortium between humans and animals for the COVID-19 pandemic.

Cross-reactive antibodies against human coronaviruses and the animal coronavirome suggest diagnostics for future zoonotic spillovers

The spillover of animal coronaviruses (aCoVs) to humans has caused SARS, MERS, and COVID-19. While antibody responses displaying cross-reactivity between SARS-CoV-2 and seasonal/common cold human coronaviruses (hCoVs) have been reported, potential cross-reactivity with aCoVs and the diagnostic implications are incompletely understood. Here, we probed for antibody binding against all seven hCoVs and 49 aCoVs represented as 12,924 peptides within a phage-displayed antigen library. Antibody repertoires of 269 recovered COVID-19 patients showed distinct changes compared to 260 unexposed pre-pandemic controls, not limited to binding of SARS-CoV-2 antigens but including binding to antigens from hCoVs and aCoVs with shared motifs to SARS-CoV-2. We isolated broadly reactive monoclonal antibodies from recovered COVID-19 patients that bind a shared motif of SARS-CoV-2, hCoV-OC43, hCoV-HKU1, and several aCoVs, demonstrating that interspecies cross-reactivity can be mediated by a single immunoglobulin. Employing antibody binding data against the entire CoV antigen library allowed accurate discrimination of recovered COVID-19 patients from unexposed individuals by machine learning. Leaving out SARS-CoV-2 antigens and relying solely on antibody binding to other hCoVs and aCoVs achieved equally accurate detection of SARS-CoV-2 infection. The ability to detect SARS-CoV-2 infection without knowledge of its unique antigens solely from cross-reactive antibody responses against other hCoVs and aCoVs suggests a potential diagnostic strategy for the early stage of future pandemics. Creating regularly updated antigen libraries representing the animal coronavirome can provide the basis for a serological assay already poised to identify infected individuals following a future zoonotic transmission event.

Environmental Sustainability Post-COVID-19: Scrutinizing Popular Hypotheses from a Social Science Perspective

There is an increasingly vocal debate on potential long-term changes in environmental sustainability spurred by the global COVID-19 pandemic. This article scrutinizes the social science basis of selected popular hypotheses regarding the nexus between the COVID-19 pandemic and the societal transitions towards environmental sustainability. It presents results that were derived through an interdisciplinary dialogue among social scientists. First, it is confirmed that the COVID-19 crisis has likely created a potential window of opportunity for societal change. Yet, to ensure that societal change is enduring and actually supporting the transition towards environmental sustainability, a clear and well-targeted political framework guiding private investments and behavior is required. Second, it is emphasized that there are important structural differences between the COVID-19 crisis and environmental crises, like time scales. Consequently, many strategies used to address the COVID-19 crisis are hardly suitable for long-term transitions towards environmental sustainability. Third, it is argued that transitions towards environmental sustainability—building both on reducing environmental degradation and building socio-techno-ecological resilience—may create co-benefits in terms of preventing and coping with potential future pandemics. However, research still needs to explore how big these synergies are (and whether trade-offs are also possible), and what type of governance framework they require to materialize.

Effect of the COVID-19 Pandemic on Patient Volumes, Acuity, and Outcomes in Pediatric Emergency Departments: A Nationwide Study

OBJECTIVES

The aim of this study was to quantify the effect of the COVID-19 pandemic on pediatric emergency department (ED) utilization and outcomes.

METHODS

This study is an interrupted-time-series observational study of children presenting to 11 Canadian tertiary-care pediatric EDs. Data were grouped into weeks in 3 study periods: prepandemic (January 1, 2018-January 27, 2020), peripandemic (January 28, 2020-March 10, 2020), and early pandemic (March 11, 2020-April 30, 2020). These periods were compared with the same time intervals in the 2 preceding calendar years. Primary outcomes were number of ED visits per week. The secondary outcomes were triage acuity, hospitalization, intensive care unit (ICU) admission, mortality, length of hospital stay, ED revisits, and visits for trauma and mental health concerns.

RESULTS

There were 577,807 ED visits (median age, 4.5 years; 52.9% male). Relative to the prepandemic period, there was a reduction [-58%; 95% confidence interval (CI), -63% to -51%] in the number of ED visits during the early-pandemic period, with concomitant higher acuity. There was a concurrent increase in the proportion of ward [odds ratio (OR), 1.39; 95% CI, 1.32-1.45] and intensive care unit (OR, 1.20; 95% CI, 1.01-1.42) admissions, and trauma-related ED visits among children less than 10 years (OR, 1.51; 95% CI, 1.45-1.56). Mental health-related visits in children declined in the early-pandemic period (in <10 years, -60%; 95% CI, -67% to -51%; in children ≥10 years: -56%; 95% CI, -63% to -47%) relative to the pre-COVID-19 period. There were no differences in mortality or length of stay; however, ED revisits within 72 hours were reduced during the early-pandemic period (percent change: -55%; 95% CI, -61% to -49%; P < 0.001).

CONCLUSIONS

After the declaration of the COVID-19 pandemic, dramatic reductions in pediatric ED visits occurred across Canada. Children seeking ED care were sicker, and there was an increase in trauma-related visits among children more than 10 years of age, whereas mental health visits declined during the early-pandemic period. When faced with a future pandemic, public health officials must consider the impact of the illness and the measures implemented on children's health and acute care needs.

Operationalisation of consensual One Health roadmaps in countries for improved IHR capacities and health security

The COVID-19 pandemic is a devastating reminder that mitigating the threat of emerging zoonotic outbreaks relies on our collective capacity to work across human health, animal health and environment sectors. Despite the critical need for shared approaches, collaborative benchmarks in the International Health Regulations (IHR) Monitoring and Evaluation Framework and more specifically the Joint External Evaluation (JEE) often reveal low levels of performance in collaborative technical areas (TAs), thus identifying a real need to work on the human-animal-environment interface to improve health security. The National Bridging Workshops (NBWs) proposed jointly by the World Organisation of Animal Health and World Health Organization (WHO) provide opportunity for national human health, animal health, environment and other relevant sectors in countries to explore the efficiency and gaps in their coordination for the management of zoonotic diseases. The results, gathered in a prioritised roadmap, support the operationalisation of the recommendations made during JEE for TAs where a multisectoral One Health approach is beneficial. For those collaborative TAs (12 out of 19 in the JEE), more than two-thirds of the recommendations can be implemented through one or multiple activities jointly agreed during NBW. Interestingly, when associated with the WHO Benchmark Tool for IHR, it appears that NBW activities are often associated with lower level of performance than anticipated during the JEE missions, revealing that countries often overestimate their capacities at the human-animal-environment interface. Deeper, more focused and more widely shared discussions between professionals highlight the need for concrete foundations of multisectoral coordination to meet goals for One Health and improved global health security through IHR.

How to study SARS-CoV-2 in soils?

Wastewater based epidemiology is increasingly being considered as a potentially useful tool for early warning about eventual new COVID-19 outbreaks. In addition, some authors are investigating on the detection and quantification of SARS-CoV-2 in sewage sludge. However, no paper has been published up to date indicating how this virus could be quantified in soil samples. In view of that, we review available data searching for methodological approaches that could guide on the quantification of SARS-CoV-2 (and even other pathogenic microorganisms) in soils.

Pandemic Prevention: Lessons from COVID-19

Coronavirus disease 2019 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which appeared in late 2019, generating a pandemic crisis with high numbers of COVID-19-related infected individuals and deaths in manifold countries worldwide. Lessons learned from COVID-19 can be used to prevent pandemic threats by designing strategies to support different policy responses, not limited to the health system, directed to reduce the risks of the emergence of novel viral agents, the diffusion of infectious diseases and negative impact in society.

Corporate Well-Being Programme in COVID-19 Times. The Mahou San Miguel Case Study

Employees’ health is being affected not only by the possibility of contracting COVID-19, but by all the negative consequences that this pandemic has brought, such as confinement, social distancing, and self-isolation. In recent decades, more companies have opted for corporate well-being programmes in their workplaces, improving the health and quality of life of their employees. The effects generated by the current COVID-19 pandemic require these programmes to adapt to this new situation. The objective of this case study is to analyse the corporate well-being programme, in times of COVID-19, of Mahou San Miguel, a benchmark company in corporate well-being in Spain. A mixed method approach to data collection was used. The findings show the benefits achieved in its adaptation to this new physical-virtual environment. This paper could help other companies around the world to adapt their corporate well-being programmes to the new reality brought about by COVID-19.

Biobehavioral Aspects of the COVID-19 Pandemic: A Review

OBJECTIVE

This review highlights the scope and significance of the coronavirus disease 2019 (COVID-19) pandemic with a focus on biobehavioral aspects and critical avenues for research.

METHODS

A narrative review of the published research literature was undertaken, highlighting major empirical findings emerging during the first and second waves of the COVID-19 pandemic.

RESULTS

Interactions among biological, behavioral, and societal processes were prominent across all regions of the globe during the first year of the COVID-19 emergency. Affective, cognitive, behavioral, socioeconomic, and technological factors all played a significant role in the spread of infection, response precautions, and outcomes of mitigation efforts. Affective symptoms, suicidality, and cognitive dysfunction have been widely described consequences of the infection, the economic fallout, and the necessary public health mitigation measures themselves. The impact of COVID-19 may be especially serious for those living with severe mental illness and/or chronic medical diseases, given the confluence of several adverse factors in a manner that appears to have syndemic potential.

CONCLUSIONS

The COVID-19 pandemic has made clear that biological and behavioral factors interact with societal processes in the infectious disease context. Empirical research examining mechanistic pathways from infection and recovery to immunological, behavioral, and emotional outcomes is critical. Examination of how emotional and behavioral factors relate to the pandemic-both as causes and as effects-can provide valuable insights that can improve management of the current pandemic and future pandemics to come.

Assessing the risks of SARS-CoV-2 in wildlife

The novel coronavirus SARS-CoV-2 likely emerged from a wildlife source with transmission to humans followed by rapid geographic spread throughout the globe and severe impacts on both human health and the global economy. Since the onset of the pandemic, there have been many instances of human-to-animal transmission involving companion, farmed and zoo animals, and limited evidence for spread into free-living wildlife. The establishment of reservoirs of infection in wild animals would create significant challenges to infection control in humans and could pose a threat to the welfare and conservation status of wildlife. We discuss the potential for exposure, onward transmission and persistence of SARS-CoV-2 in an initial selection of wild mammals (bats, canids, felids, mustelids, great apes, rodents and cervids). Dynamic risk assessment and targeted surveillance are important tools for the early detection of infection in wildlife, and here we describe a framework for collating and synthesising emerging information to inform targeted surveillance for SARS-CoV-2 in wildlife. Surveillance efforts should be integrated with information from public and veterinary health initiatives to provide insights into the potential role of wild mammals in the epidemiology of SARS-CoV-2.

Tackling zoonoses in a crowded world: Lessons to be learned from the COVID-19 pandemic

The COVID-19 zoonosis is bringing about a number of lessons to humanity. One is that of transforming our links with nature and, particularly, wildlife given the likely COVID-19 origin from illegal wildlife trading. Similar to vector borne diseases (VBD, diseases transmitted by vectors), the COVID-19 pandemic follows related patterns (e.g. no effective or available vaccines, difficult to diagnose, highly localized infection geographical foci, non-human reservoirs) for which we urgently need preventive measures. Towards this aim, governments worldwide must strive to prevent further devastation of natural environments that serve as buffer areas to humans against zoonotic agents (among other health risks), protecting biodiversity and its concomitant causes (e.g. global change), and banning use of wildlife of illegal origin. We herein state that some VBD prevention strategies could also be applied to zoonotic disease prevention, including COVID-19 or any type likely to be related to environmental conditions. The occurrence of future pandemic occurrence will depend on whether governments embrace these aims now.

Control and prevention of infectious diseases from a One Health perspective

The ongoing COVID-19 pandemic has caught the attention of the global community and rekindled the debate about our ability to prevent and manage outbreaks, epidemics, and pandemics. Many alternatives are suggested to address these urgent issues. Some of them are quite interesting, but with little practical application in the short or medium term. To realistically control infectious diseases, human, animal, and environmental factors need to be considered together, based on the One Health perspective. In this article, we highlight the most effective initiatives for the control and prevention of infectious diseases: vaccination; environmental sanitation; vector control; social programs that encourage a reduction in the population growth; control of urbanization; safe sex stimulation; testing; treatment of sexually and vertically transmitted infections; promotion of personal hygiene practices; food safety and proper nutrition; reduction of the human contact with wildlife and livestock; reduction of social inequalities; infectious disease surveillance; and biodiversity preservation. Subsequently, this article highlights the impacts of human genetics on susceptibility to infections and disease progression, using the SARS-CoV-2 infection as a study model. Finally, actions focused on mitigation of outbreaks and epidemics and the importance of conservation of ecosystems and translational ecology as public health strategies are also discussed.

The Ecology of Nipah Virus in Bangladesh: A Nexus of Land-Use Change and Opportunistic Feeding Behavior in Bats

Nipah virus is a bat-borne paramyxovirus that produces yearly outbreaks of fatal encephalitis in Bangladesh. Understanding the ecological conditions that lead to spillover from bats to humans can assist in designing effective interventions. To investigate the current and historical processes that drive Nipah spillover in Bangladesh, we analyzed the relationship among spillover events and climatic conditions, the spatial distribution and size of Pteropus medius roosts, and patterns of land-use change in Bangladesh over the last 300 years. We found that 53% of annual variation in winter spillovers is explained by winter temperature, which may affect bat behavior, physiology, and human risk behaviors. We infer from changes in forest cover that a progressive shift in bat roosting behavior occurred over hundreds of years, producing the current system where a majority of P. medius populations are small (median of 150 bats), occupy roost sites for 10 years or more, live in areas of high human population density, and opportunistically feed on cultivated food resources-conditions that promote viral spillover. Without interventions, continuing anthropogenic pressure on bat populations similar to what has occurred in Bangladesh could result in more regular spillovers of other bat viruses, including Hendra and Ebola viruses.

SARS-CoV-2 and other pathogens could be determined in liquid samples from soils

In the current COVID-19 pandemic, SARS-CoV-2 has been quantified in wastewater in various countries, and wastewater based epidemiology has been proposed as a potential early warning tool for new outbreaks. However, even taking into account that poorly treated wastewater and sewage sludge may be spread on soils, there is no published paper dealing with the quantification of the virus in soil-related liquid samples, as could be runoff, leachates, or soil solution. To fill this gap, the authors of this piece propose reflections on the development of a methodological approach for the quantification of SARS-CoV-2 (and eventually other pathogens) in soil-related liquid samples.

Human Coronaviruses SARS-CoV, MERS-CoV, and SARS-CoV-2 in Children

The novel coronavirus, known as 2019-nCoV or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an epidemic with high mortality and morbidity since December 2019, in Wuhan, China. The infection has now been transmitted to more than 210 countries worldwide and caused more than 200,000 deaths. Similar to other coronaviruses such as Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), SARS-CoV-2 appears to less commonly affect pediatrics and to cause less severe disease along with fewer symptoms compared to adults. Available data suggest that the pediatric population is just as likely as adults to become infected with SARS-CoV-2. However, they may be asymptotic or have milder symptoms than adults; they can be potential carriers of the disease. This article reviews the present understanding of SARS-CoV-2 infection in the pediatric age group in comparison with MERS-CoV and SARS-CoV.

Interface between Bats and Pigs in Heavy Pig Production

Bats are often claimed to be a major source for future viral epidemics, as they are associated with several viruses with zoonotic potential. Here we describe the presence and biodiversity of bats associated with intensive pig farms devoted to the production of heavy pigs in northern Italy. Since chiropters or signs of their presence were not found within animal shelters in our study area, we suggest that fecal viruses with high environmental resistance have the highest likelihood for spillover through indirect transmission. In turn, we investigated the circulation of mammalian orthoreoviruses (MRVs), coronaviruses (CoVs) and astroviruses (AstVs) in pigs and bats sharing the same environment. Results of our preliminary study did not show any bat virus in pigs suggesting that spillover from these animals is rare. However, several AstVs, CoVs and MRVs circulated undetected in pigs. Among those, one MRV was a reassortant strain carrying viral genes likely acquired from bats. On the other hand, we found a swine AstV and a MRV strain carrying swine genes in bat guano, indicating that viral exchange at the bat–pig interface might occur more frequently from pigs to bats rather than the other way around. Considering the indoor farming system as the most common system in the European Union (EU), preventive measures should focus on biosecurity rather than displacement of bats, which are protected throughout the EU and provide critical ecosystem services for rural settings.

Tetravalent SARS-CoV-2 Neutralizing Antibodies Show Enhanced Potency and Resistance to Escape Mutations

Neutralizing antibodies (nAbs) hold promise as effective therapeutics against COVID-19. Here, we describe protein engineering and modular design principles that have led to the development of synthetic bivalent and tetravalent nAbs against SARS-CoV-2. The best nAb targets the host receptor binding site of the viral S-protein and its tetravalent versions can block entry with a potency that exceeds the bivalent nAbs by an order of magnitude. Structural studies show that both the bivalent and tetravalent nAbs can make multivalent interactions with a single S-protein trimer, observations consistent with the avidity and potency of these molecules. Significantly, we show that the tetravalent nAbs show much increased tolerance to potential virus escape mutants. Bivalent and tetravalent nAbs can be produced at large-scale and are as stable and specific as approved antibody drugs. Our results provide a general framework for developing potent antiviral therapies against COVID-19 and related viral threats, and our strategy can be readily applied to any antibody drug currently in development.

Utilisation of healthcare services for respiratory tract infections in patients with and without diabetes in Qatar: a cross-sectional study

OBJECTIVE

People with diabetes mellitus have a high risk of acquiring respiratory tract infections (RTIs), yet little is known about their utilisation of healthcare services compared with people without diabetes. This study aimed to compare the utilisation of healthcare services for RTIs between individuals with and without diabetes attending primary healthcare centres (PHCCs) in Qatar.

DESIGN

A retrospective cross-sectional study was conducted using an electronic database of all individuals who had a diagnosis of RTI.

SETTING

PHCCs in Qatar from July 2015 to December 2017.

PARTICIPANTS

Participants in the study were all adult individuals (aged ≥18 years) who visited the primary healthcare facilities and were diagnosed with an RTI during the study period.

PRIMARY AND OUTCOME MEASURES

For each participant, visits to the healthcare facility, antibiotic use and use of other medications were extracted from the electronic database and compared between participants with and without a diabetes diagnosis.

RESULTS

A total of 32 857 participants were included, of whom 7407 (22.5%) had a diabetes diagnosis. Results from a negative binomial regression indicate that diabetes diagnosis was significantly associated with increased visits to the healthcare facility (incidence rate ratio (IRR) 1.10, 95% CI 1.076 to 1.134, p<0.001), antibiotic use (IRR 1.09, 95% CI 1.046 to 1.145, p<0.001) and use of other medications (IRR 1.11, 95% CI 1.078 to 1.143, p<0.001).

CONCLUSIONS

A diabetes diagnosis among patients with RTI was associated with higher utilisation of healthcare services. Given the added costs to the healthcare system, prevention of diabetes will have additional benefits to the healthcare system, apart from diabetes-associated costs alone.

COVID-19: animals, veterinary and zoonotic links

Coronavirus disease 2019 (COVID-19), has spread over 210 countries and territories beyond China shortly. On February 29, 2020, the World Health Organization (WHO) denoted it in a high-risk category, and on March 11, 2020, this virus was designated pandemic, after its declaration being a Public Health International Emergency on January 30, 2020. World over high efforts are being made to counter and contain this virus. The COVID-19 outbreak once again proves the potential of the animal-human interface to act as the primary source of emerging zoonotic diseases. Even though the circumstantial evidence suggests the possibility of an initial zoonotic emergence, it is too early to confirm the role of intermediate hosts such as snakes, pangolins, turtles, and other wild animals in the origin of SARS-CoV-2, in addition to bats, the natural hosts of multiple coronaviruses such as SARS-CoV and MERS-CoV. The lessons learned from past episodes of MERS-CoV and SARS-CoV are being exploited to retort this virus. Best efforts are being taken up by worldwide nations to implement effective diagnosis, strict vigilance, heightened surveillance, and monitoring, along with adopting appropriate preventive and control strategies. Identifying the possible zoonotic emergence and the exact mechanism responsible for its initial transmission will help us to design and implement appropriate preventive barriers against the further transmission of SARS-CoV-2. This review discusses in brief about the COVID-19/SARS-CoV-2 with a particular focus on the role of animals, the veterinary and associated zoonotic links along with prevention and control strategies based on One-health approaches.

One Health in the context of coronavirus outbreaks: A systematic literature review

The ongoing coronavirus disease 2019 (COVID-19) pandemic threatens global health thereby causing unprecedented social, economic, and political disruptions. One way to prevent such a pandemic is through interventions at the human-animal-environment interface by using an integrated One Health (OH) approach. This systematic literature review documented the three coronavirus outbreaks, i.e. SARS, MERS, COVID-19, to evaluate the evolution of the OH approach, including the identification of key OH actions taken for prevention, response, and control. The OH understandings identified were categorized into three distinct patterns: institutional coordination and collaboration, OH in action/implementation, and extended OH (i.e. a clear involvement of the environmental domain). Across all studies, OH was most often framed as OH in action/implementation and least often in its extended meaning. Utilizing OH as institutional coordination and collaboration and the extended OH both increased over time. OH actions were classified into twelve sub-groups and further categorized as classical OH actions (i.e. at the human-animal interface), classical OH actions with outcomes to the environment, and extended OH actions. The majority of studies focused on human-animal interaction, giving less attention to the natural and built environment. Different understandings of the OH approach in practice and several practical limitations might hinder current efforts to achieve the operationalization of OH by combining institutional coordination and collaboration with specific OH actions. The actions identified here are a valuable starting point for evaluating the stage of OH development in different settings. This study showed that by moving beyond the classical OH approach and its actions towards a more extended understanding, OH can unfold its entire capacity thereby improving preparedness and mitigating the impacts of the next outbreak.