One Health and the COVID-19 pandemic.

Abstract

At the beginning of the spring 2020 semester, in the latest iteration of my Ecology of Infectious Disease class, I explained the relatively frequent phenomenon known as “zoonotic spillover” – when a pathogen jumps from an animal host species into a human population. Throughout each semester's class we habitually follow the emergence of a zoonosis. In recent years, we have monitored swine flu, MERS, and Ebola virus…and earlier this year I noted that students ought to keep a close eye on the status of a “Wuhan virus”, a novel coronavirus that at the time had yet to be officially named. We discussed the difficulty of identifying the wildlife species that originally harbored the virus associated with COVID-19 (the reservoir host), just like SARS before it, and tracked the various potential red herrings present at the Wuhan wet market: snakes, pangolins, and bats. And we started to concede that the virus was probably spreading in human populations before the outbreak that is now associated with the Huanan Seafood Wholesale Market. We watched the 2011 movie Contagion as a lens through which to understand the issues, though, of course, it was a Hollywood take on a slightly preposterous scenario where a virus causes global lockdowns and unrealistic death rates. I had no preconception that this real-world outbreak would be remembered like few others. That the class would move online, and that all of us would be socially distant and at home for the rest of the semester. That nearly a third of the globe would experience some degree of “lockdown”. At the time of writing – late June – the world has surpassed 9,290,000 confirmed cases and 479,000 deaths (both likely underestimates). In places, the impact has exceeded that of hurricanes, terrorist events, and the Spanish flu. And the impact on economies and employment is unprecedented and only just beginning. I had no idea that so many global leaders and their advisors would have failed my class this spring. We saw them eschew public health responses, hope for nationwide herd immunity, and advocate the use of bleach or injected UV light as potential cures. I did not foresee the scientific ambulance-chasing cavalcade to publish without an appropriate understanding of not only sampling bias in host surveillance but also test validity, or without knowing how to build phylogenies. And I have wrestled with ethical dilemmas. If put in the position, would I be able to speak truth to power, especially given the degree of scientific uncertainty? Would I be willing to go to work as a health care provider and risk exposure to the virus, like my sister and brother-in-law? Or keep going to work in a supermarket, in a prison, or in the public transport sector? So – as an ecologist – are there silver linings to the coronavirus cloud? Perhaps the pandemic is a shining (glaring?) example of the usefulness of the One Health approach. For those unfamiliar with the concept, One Health advocates for interdisciplinary recognition that the health of humans, wildlife, and the environment are linked. I get frustrated when One Health is used as a term that simply describes obvious truths: that animals and humans can share diseases, or that environmental factors can influence the incidence of zoonoses. But I get excited when One Health galvanizes us to look at ways to optimize clever upstream solutions to mitigate adverse health impacts. As the lockdown has quashed travel and business, we have observed new trajectories of air quality (including pollution emissions), mass tourism, and wildlife behavior. We have glimpsed the dramatic impacts on environmental health that are achievable if we modify our actions. There is growing recognition that investment in health, rather than military defense or stock markets, should be considered prudent and beneficial. And it's clear that we can get the response right and use science and intelligence to curb the virus’ spread (think New Zealand, South Korea, and Vietnam). We have watched as the response to COVID-19 has laid bare the inadequacies in our societies, and highlighted injustices to the US's Black and other minority populations, which have borne the brunt of COVID-19's impacts. The pent-up frustration and dire economic situation of the past few months have been exacerbated by and become rightfully conflated with entrenched racial inequalities. Could 2020 be the start of a One Health global initiative, where social change, health, and the environment begin to emerge as critical guiding lights for our global decision-makers? Or will we quietly forget these critical lessons that have emerged at the cost of lost lives and livelihoods in the last six months? DAN SALKELD Colorado State University, Fort Collins, CO