Abstract
The health and economic impacts of infectious disease pandemics are catastrophic as most recently manifested by coronavirus disease 2019 (COVID-19). The emerging infections that lead to substantive epidemics or pandemics are typically zoonoses that cross species boundaries at vulnerable points of animal-human interface. The sharing of space between wildlife and humans, and their domesticated animals, has dramatically increased in recent decades and is a key driver of pathogen spillover. Increasing animal-human interface has also occurred in concert with both increasing globalisation and failing health systems, resulting in a trifecta with dire implications for human and animal health. Nevertheless, to date we lack a geographical description of this trifecta that can be applied strategically to pandemic prevention. This investigation provides the first geographical quantification of the intersection of animal-human interfaces, poor human health system performance and global connectivity via the network of air travel. In so doing, this work provides a systematic, data-driven approach to classifying spillover hazard based on the distribution of animal-human interfaces while simultaneously identifying globally connected cities that are adjacent to these interfaces and which may facilitate global pathogen dissemination. We present this geography of high-impact spillover as a tool for developing targeted surveillance systems and improved health infrastructure in vulnerable areas that may present conduits for future pandemics.
Highlights
The global spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in 2020 has shown how rapidly emerging infectious diseases can devastate human health and national economies
This work has defined a hierarchical geography of potential high-impact spillover based on variable animal-human interfaces, human health system capacity and their proximate cities of high global connectivity
More than 40% of these cities were within or adjacent to landscapes of extensive animal-human interface, while approximately 14%-20% were located in landscapes of both extensive interface and poor health system performance, demonstrating the precarious positioning of many global transportation hubs
Summary
The global spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in 2020 has shown how rapidly emerging infectious diseases can devastate human health and national economies Such infections typically have zoonotic origins, with other notable examples being SARS-CoV in 20021, influenza A H1N1 virus in 20092, and the West African Ebola virus disease epidemic of 2013-20163. Emerging infectious diseases are increasing in incidence and expanding in geographic range due in large part to direct and diffuse anthropogenic pressure across ecosystems[4] This is true in areas with high wildlife biodiversity that are experiencing land-use changes such as deforestation , 4,5,6,7 the process of disease emergence is complex and cannot be attributed to any one driver. Differential impact of specific taxa on spillover has been recently challenged by research showing that overall species richness (rather than taxonomy) is the primary driver of pathogen richness among mammalian and bird reservoir hosts[10]
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