Coronavirus Epidemic Research Articles

Epidemiology and evolution of novel deltacoronaviruses in birds in central China.

The variety and widespread of coronavirus in natural reservoir animals is likely to cause epidemics via interspecific transmission, which has attracted much attention due to frequent coronavirus epidemics in recent decades. Birds are natural reservoir of various viruses, but the existence of coronaviruses in wild birds in central China has been barely studied. Some bird coronaviruses belong to the genus of Deltacoronavirus. To explore the diversity of bird deltacoronaviruses in central China, we tested faecal samples from 415 wild birds in Hunan Province, China. By RT‐PCR detection, we identified eight samples positive for deltacoronaviruses which were all from common magpies, and in four of them, we successfully amplified complete deltacoronavirus genomes distinct from currently known deltacoronavirus, indicating four novel deltacoronavirus stains (HNU1‐1, HNU1‐2, HNU2 and HNU3). Comparative analysis on the four genomic sequences showed that these novel magpie deltacoronaviruses shared three different S genes among which the S genes of HNU1‐1 and HNU1‐2 showed 93.8% amino acid (aa) identity to that of thrush coronavirus HKU12, HNU2 S showed 71.9% aa identity to that of White‐eye coronavirus HKU16, and HNU3 S showed 72.4% aa identity to that of sparrow coronavirus HKU17. Recombination analysis showed that frequent recombination events of the S genes occurred among these deltacoronavirus strains. Two novel putative cleavage sites separating the non‐structural proteins in the HNU coronaviruses were found. Bayesian phylogeographic analysis showed that the south coast of China might be a potential origin of bird deltacoronaviruses existing in inland China. In summary, these results suggest that common magpie in China carries diverse deltacoronaviruses with novel genomic features, indicating an important source of environmental coronaviruses closed to human communities, which may provide key information for prevention and control of future coronavirus epidemics.

666 Innovations in ENT Surgery During The COVID-19 Pandemic

IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-COV-2), is responsible for the coronavirus disease 2019 (COVID – 19) global pandemic. Similar coronavirus epidemics over the past years affected healthcare workers significantly. Aerosol generating procedures (AGPs) presented a unique risk to ear, nose and throat (ENT) Surgeons. We introduce various methods of reducing risk in ENT AGPs.RecommendationsDuring trachesostomies we advocate the adoption of a specialist checklist based on ENT UK guidelines.We also advise the use of a clear drape to create a clear barrier between the patient and staff.For ear surgery we advise suturing 2 microscope pieces together end-to-end so that a clear drape can sperate the patient from surgeon.During nasal and sinus surgery, we advise attaching a clear drape to the sterile camera drape used in rigid nasal endoscopy to create a barrier between patient and surgeon.DiscussionOur recommendations will create an extra barrier between the patient and the rest of healthcare team. This should reduce the risks to theatre staff from AGPs.ConclusionsCOVID 19 is a serious health issue affecting healthcare workers, especially during AGPs in ENT surgery. We recommend several techniques to reduce risk. These can also be used during future epidemics.

PANDEMIC COVID-19: COMPARATIVE STUDY OF SOCIAL AND SCIENTIFIC DEVELOPMENTS BY PUNJAB AND SINDH GOVERNMENTS IN PAKISTAN

Purpose: The study analyzes the growing situation of Covid-19 in Pakistan and highlights the recent scientific and social developments made during this pandemic. The paper highlights the exertions of the government of Pakistan in general and especially the preventing measures taken by the Punjab and Sindh government to fight this pandemic. The paper discusses the emergency preparedness and response to the Covid-19 in Pakistan. Method: This research uses publicly available data to inspect the current situation of epidemic Covid-19 and its preventive measures in Pakistan, especially in Punjab and Sindh province. Besides, documents on the website of the daily situation report of NIH (National Institute of Health), WHO covid-19 dashboard (services and coordination) Ministry of National Health Regulation, different scholarly articles, and already existing world reports have been reviewed and analyzed Main Findings: The outbreak of Covid-19 was experienced first time in December 2019 at Wuhan city of China which spread promptly in China and then all-inclusive in 213 other countries including Australia, Asia, Europe, America, and Pakistan as well. Experts believed that in a developing country like Pakistan, its effects would be devastating. It has caused approximately 2, 862, 664 deaths and affected more than 131, 837, 512 people worldwide, while its statistics are growing fast. However, several steps have been adopted to overcome Covid-19 worldwide. Even, drastic measures were taken with limited resources in Pakistan to curb the growing situation of Covid-19 such as lockdown, awareness campaign, quarantine facilities, special hospitals, and laboratories for testing the virus. Application of the Study: The results of this research help the Pakistani government to make their policies more target-ordinated and systematic to cure this pandemic to restore its vigilance with available resources against Covid-19 and trained human capacities, laboratory networks, policy formulation, and national emergency preparedness. The originality of the Study: This research contributes that confusion and uncertainty between the policies of the federal government and provinces on lockdown measures could lead the thousands of untimely deaths. Experts believed that in a developing country like Pakistan, its effects would be devastating. Despite its limited resources, Pakistan took a stand against an epidemic coronavirus and made it a single-point agenda by all the provinces of Pakistan.

Exploring the Attitudes of Patients towards using the Seha Application (Telehealth) in Saudi Arabia during the Coronavirus Epidemic

Background: The COVID-19 pandemic that was declared in March 2020, caused profound changes to public life across the globe. Restrictions to reduce the spread of the virus were enforced that included staying at home and minimizing social interaction. These changes saw an environment emerge that demanded remote healthcare, and telehealth platforms and applications quickly began to fulfill this demand. One such platform in Saudi Arabia was Seha, a Ministry of Health smartphone application that provides information, self-evaluation, and teleconsultations. Purpose: To explore Seha users’ (patients) attitudes toward the Seha smartphone application during the COVID-19 pandemic. Methods: A qualitative, grounded theory approach using thematic analysis of data collected through open-ended semi-structured interviews with seventeen residents of Jeddah. Results: Three themes emerged – 1) COVID-19 and usage patterns, as Seha helped patients reduce person-to-person contact and usage increased, especially for emergencies; 2) ease of use and access, especially to approved doctors and reliable information; 3) time and cost savings, although it was also noted that these are more readily available to individuals and areas with access to sufficient internet infrastructure. Discussion: Concerns were raised about technical issues or misdiagnoses when using Seha for emergency cases, as the platform may prove unsuitable. Traditional barriers to telehealth adoption seemed to be absent, but these may re-emerge when the immediate crisis is over. Further issues concerned the diminishment of the doctor-patient relationship, especially the lack of information on doctors’ profiles, problems that may be experienced by older people, and lack of language variety. These lead to access problems that may be critical in a pandemic or emergency situation. Finally, the ‘digital divide’ may result in increased health inequality, and such an outcome must be avoided. Conclusion: The pandemic has shown telehealth applications like Seha to be a crucial tool in controlling infection rates, but the loss of face-to-face interaction with medical professionals, technical disparities, and access difficulties for certain groups may present problems for the Saudi health system unless they are taken into account and telehealth is carefully implemented into the system along with appropriate investment in infrastructure.

A longer look at COVID-19 and neuropsychiatric outcomes

Early in the pandemic, concerns were raised about the potential for serious and widespread neurological and psychiatric adverse outcomes following COVID-19, on the basis of a systematic review of observational studies done in patients infected during previous coronavirus epidemics.1 Interpretation was hampered by the absence of a comparison group of individuals who had similar infections. The first large-scale attempt to redress this issue was published by Maxime Taquet and colleagues2 who found, using real-world data, that a first psychiatric diagnosis was more common in patients with COVID-19 in the 14–90 days after SARS-CoV-2 infection than in those with several other acute illnesses.

Short-term forecasts of expected deaths

We introduce a method for making short-term mortality forecasts of a few months, illustrating it by estimating how many deaths might have happened if some major shock had not occurred. We apply the method to assess excess mortality from March to June 2020 in Denmark and Sweden as a result of the first wave of the coronavirus pandemic; associated policy interventions; and behavioral, healthcare, social, and economic changes. We chose to compare Denmark and Sweden because reliable data were available and because the two countries are similar but chose different responses to COVID-19: Denmark imposed a rather severe lockdown; Sweden did not. We make forecasts by age and sex to predict expected deaths if COVID-19 had not struck. Subtracting these forecasts from observed deaths gives the excess death count. Excess deaths were lower in Denmark than Sweden during the first wave of the pandemic. The later/earlier ratio we propose for shortcasting is easy to understand, requires less data than more elaborate approaches, and may be useful in many countries in making both predictions about the future and the past to study the impact on mortality of coronavirus and other epidemics. In the application to Denmark and Sweden, prediction intervals are narrower and bias is less than when forecasts are based on averages of the last 5 y, as is often done. More generally, later/earlier ratios may prove useful in short-term forecasting of illnesses and births as well as economic and other activity that varies seasonally or periodically.

Post-acute COVID-19 syndrome.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.

The prevalence of psychiatric comorbidities during the SARS and COVID-19 epidemics: a systematic review and meta-analysis of observational studies

The coronavirus disease 2019 (COVID-19) and Severe Acute Respiratory Syndrome (SARS) are associated with various psychiatric comorbidities. This is a systematic review and meta-analysis comparing the prevalence of psychiatric comorbidities in all subpopulations during the SARS and COVID-19 epidemics. A systematic literature search was conducted in major international (PubMed, EMBASE, Web of Science, PsycINFO) and Chinese (China National Knowledge Internet [CNKI] and Wanfang) databases to identify studies reporting prevalence of psychiatric comorbidities in all subpopulations during the SARS and COVID-19 epidemics. Data analyses were conducted using the Comprehensive Meta-Analysis Version 2.0 (CMA V2.0). Eighty-two studies involving 96,100 participants were included. The overall prevalence of depressive symptoms (depression hereinafter), anxiety symptoms (anxiety hereinafter), stress, distress, insomnia symptoms, post-traumatic stress symptoms (PTSS) and poor mental health during the COVID-19 epidemic were 23.9% (95% CI: 18.4%-30.3%), 23.4% (95% CI: 19.9%-27.3%), 14.2% (95% CI: 8.4%-22.9%), 16.0% (95% CI: 8.4%-28.5%), 26.5% (95% CI: 19.1%-35.5%), 24.9% (95% CI: 11.0%-46.8%), and 19.9% (95% CI: 11.7%-31.9%), respectively. Prevalence of poor mental health was higher in general populations than in health professionals (29.0% vs. 11.6%; Q=10.99, p=0.001). The prevalence of depression, anxiety, PTSS and poor mental health were similar between SARS and COVID-19 epidemics (all p values>0.05). Psychiatric comorbidities were common in different subpopulations during both the SARS and COVID-19 epidemics. Considering the negative impact of psychiatric comorbidities on health and wellbeing, timely screening and appropriate interventions for psychiatric comorbidities should be conducted for subpopulations affected by such serious epidemics.

A Comparative Analysis of the Information Published in the Largest News Portals in Poland at the Beginning of the Coronavirus Epidemic

The coronavirus has dominated the work of Polish online publications for several months. Every day, the largest portals in the country outdid one another in providing us with information about the subsequent illnesses and consequences of the epidemic. However, the first infection in the country was crucial for them. In my comparative analysis, I focus on how the beginning of the epidemic in Poland was reported in the largest news portals in Poland.

Overcoming the Challenge of Communicating the Concept and Science of SARS-CoV-2 and COVID-19 to Non-Experts

Recent studies show that inadequate knowledge and understanding about the SARS-CoV-2 and COVID-19 by many people has contributed significantly to fueling the conspiracy theories and misinformation about the pandemic. This challenge further impacts people’s behavior against public health guidelines in observing social distancing, wearing a facial mask, or self-isolation if exposed to imminent threats. This article attempts to use visual presentation and theoretical narratives to explain the science and conceptual structure of SARS-CoV-2 and COVID-19. The paper also shows a visualization of the connections between the ongoing pandemic and previous coronavirus outbreaks and epidemics.

Coronaviruses in humans and animals: the role of bats in viral evolution.

Bats act as a natural reservoir for many viruses, including coronaviruses, and have played a crucial epidemiological role in the emergence of many viral diseases. Coronaviruses have been known for 60 years. They are usually responsible for the induction of mild respiratory signs in humans. However, since 2002, the bat-borne virus started to induce fatal epidemics according to WHO reports. In this year, the first serious human coronavirus epidemic (severe acute respiratory syndrome; SARS) occurred (China, 8098 cases, 774 deaths [9.5% of the cases] in 17 countries). The case fatality was higher in elderly patients above 60 years and reached 50% of the cases. SARS epidemic was followed 10 years later by the emergence of the middle east respiratory syndrome (MERS) in Saudi Arabia (in 2012, 2260 cases, 803 deaths [35.5% of the cases] in 27 countries). Finally, in December 2019, a new epidemic in Wuhan, China, (corona virus disease 2019, COVID-19) emerged and could spread to 217 countries infecting more than 86,255,226 cases and killing 1,863,973 people by the end of 2020. There are many reasons why bats are ideal reservoir hosts for viral diseases such as the tolerance of their immune system to the invading viruses for several months. They can actively shed the viruses, although they develop no clinical signs (will be discussed in details later in the review). Bats were directly or indirectly involved in the three previous coronavirus epidemics. The indirect transmission takes place via intermediate hosts including civet cats for SARS and dromedary camels in the case of MERS. Although bats are believed to be the source of COVID-19 pandemic, direct pieces of evidence are still lacking. Therefore, coronaviruses’ role in epidemics induction and the epidemiological role of bats are discussed. The current work also presents different evidence (phylogenetic data, animal experiments, bats artificial infection studies, and computerized models of SARS-CoV2 evolution) that underline the involvement of bats in the epidemiology of the pandemic.

Regional Organization of the Rehabilitation Service in Coronavirus Epidemic

The COVID-19 pandemics has dramatically changed the organization of public rehabilitation services around the world. Rehabilitation managers and doctors have faced different challenges at all stages of patient management from acute departments to home, especially in the periphery of the country. Aim. To analyze and present the regional experience of rehabilitation system reorganization during pandemics. Materials and methods. The Southern region of Israel is a big part of the country with about one million of population. The Physical Medicine and Rehabilitation department at the Soroka University Hospital is a part of the regional rehabilitation network, and was forced to find optimal solutions to all kinds of organizational challenges from the first days of the crisis. Most of those solutions, which, in our opinion, showed their effectiveness in managing our patients in this confused situation are presented and discussed in the article. Results. COVID-19 pandemics crisis had mostly a negative input on the whole system organization. The normal regular flow of multistage rehabilitation process was interrupted, serious part of professional staff was out of system due to quarantine and pandemic restrictions. The whole system was forced to change the management algorithms very quickly, sometimes as an immediate response to everyday changes. However, some changes that have occurred in response to the changed conditions may have a positive impact on the work of the rehabilitation system in the future and will also be discussed in the article. Conclusion. Our regional professional situation, of sure, is a combination of local rehabilitation organization and characteristics of Israeli health system, and from that point of view it is quite unique. But the problems of periphery are almost the same in every country so our local experience can help professionals in other regions.

Covid-19 and Korean Buddhism: Assessing the Impact of South Korea’s Coronavirus Epidemic on the Future of Its Buddhist Community

While the Covid-19 pandemic has altered many aspects of life in South Korea over 2020, its impact on South Korea’s religious landscape has been enormous as the country’s three major religions (Catholicism, Buddhism, and Protestant Christianity) have suffered considerable loses in both their income and membership. Despite these challenges, however, Buddhism’s public image has actually improved since the start of the epidemic due to the rapid and proactive responses of the nation’s largest Buddhist organization, the Jogye Order of Korean Buddhism (K. Daehan bulgyo jogyejong). This article critically examines the Jogye Order’s response to the epidemic and its impact on the order thus far, along with discussions regarding the order’s future. In particular it will examine the results of three conferences held by the order in response to the epidemic and the resulting recommendations on how Korean Buddhism should adapt to effectively address the many challenges brought by the pandemic. These recommendations include establishing an online Buddhist education system, further engaging the order’s lay supporters through various social media platforms, upgrading the current lay education program with virtual learning options that directly address problems faced by the general public during the pandemic, and distributing virtual meditation classes world-wide for those who remain in quarantine or social isolation. By adopting these changes, the Jogye Order will be able to play a crucial role in promoting mental stability and the cultivation of positive emotions among the many suffering from anxiety, social isolation and financial difficulties during the pandemic.

A Half-Day Genome Sequencing Protocol for Middle East Respiratory Syndrome Coronavirus.

Recent coronavirus (CoV) outbreaks, including that of Middle East respiratory syndrome (MERS), have presented a threat to public health worldwide. A primary concern in these outbreaks is the extent of mutations in the CoV, and the content of viral variation that can be determined only by whole genome sequencing (WGS). We aimed to develop a time efficient WGS protocol, using universal primers spanning the entire MERS-CoV genome. MERS and synthetic Neoromicia capensis bat CoV genomes were successfully amplified using our developed PCR primer set and sequenced with MinION. All experimental and analytical processes took 6 h to complete and were also applied to synthetic animal serum samples, wherein the MERS-CoV genome sequence was completely recovered. Results showed that the complete genome of MERS-CoV and related variants could be directly obtained from clinical samples within half a day. Consequently, this method will contribute to rapid MERS diagnosis, particularly in future CoV epidemics.

Mental Health of Medical Staff During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis.

This study aimed to quantify the prevalence of the adverse mental health outcomes in medical staff working in the hospital settings during the coronavirus disease 2019 (COVID-19) pandemic and explore the relative distribution of anxiety and depressive symptoms. PubMed, EMBASE, China National Knowledge Infrastructure, WANFANG DATA, and VIP Database for Chinese Technical Periodicals were searched for articles published from January 1, 2019, to April 19, 2020. The prevalence estimates of adverse mental health symptoms in medical staff were pooled using the random-effects model. A total of 35 articles and data of 25,343 medical staff were used in the final analysis. The pooled prevalence estimates in medical staff during the COVID-19 pandemic were as follows (ordered from high to low): fear-related symptoms, 67% (95% confidence interval [CI] = 61%-73%); high levels of perceived stress, 56% (95% CI = 32%-79%), anxiety symptoms, 41% (95% CI = 35%-47%); insomnia, 41% (95% CI = 33%-50%); posttraumatic stress disorder symptoms, 38% (95% CI = 34%-43%); depressive symptoms, 27% (95% CI = 20%-34%); and somatic symptoms, 16% (95% CI = 3%-36%). The subgroup analysis revealed that the prevalence estimates of fear-related symptoms were consistently high. Medical staff during the COVID-19 epidemic have a high prevalence of adverse mental health symptoms. Data-based strategies are needed to optimize mental health of medical staff and other health care professionals during times of high demand such as the COVID-19 and other epidemics.PROSPERO Registration: CRD42020182433.

Chemokine Regulation During Epidemic Coronavirus Infection.

SARS-CoV-2 (Severe Acute Respiratory Syndrome coronavirus-2) is the third coronavirus to emerge as a cause of severe and frequently fatal pneumonia epidemics in humans, joining SARS-CoV and MERS-CoV (Middle East Respiratory Syndrome-coronavirus). As with many infectious diseases, the immune response to coronavirus infection may act as a double-edged sword: necessary for promoting antiviral host defense, but, if not appropriately regulated, also able to incite life-threatening immunopathology. Key immunoregulatory mediators include the chemokines, a large family of leukocyte chemoattractants that coordinate leukocyte infiltration, positioning and activation in infected tissue by acting at specific G protein-coupled receptors. Here, we compare the involvement of chemokines and chemokine receptors during infection with the three epidemic coronaviruses and discuss their potential value as biomarkers and targets for therapeutic development.

The Application of Hazard Vulnerability Analysis in the Prevention and Control of COVID-19 in Medical Institutions.

Background:Coronavirus disease 2019 (COVID-19) has caused massive casualties, severe economic losses, and poses a threat to the world. This study’s primary objective was to analyze the hospital’s potential hazards of COVID-19 prevention and control. The second objective was to review the disaster plan and make recommendations to minimize the spread of COVID-19 in hospitals.Methods:An expert group for the prevention and control of COVID-19 in the First People’s Hospital of Long-quanyi Dis-trict, Chengdu, China was established. We adopted the hazard vulnerability analysis (HVA) to risk-stratify potential hazards and calculated relative risk values. We used the Delphi expert consultation method to propose and implement targeted improvement measures for the top five potential hazards. Then, the effects before and after the intervention were compared.Results:The top five hazards were: insufficient Personal Protective Equipment (PPE) (25.68%), inadequate diagnosis ability of clinicians (22.55%), and inadequate management strategies of patients and caregivers (22.38%), lack of professional ability of pre-checking and triage staff (16.96%), lack of knowledge of COVID-19 of medical staff (15.59%). After taking targeted improvement measures, the average score of the hospital staff’s COVID-19 knowledge test increased from 73.26 points to 90.44 points, the average test score of the outsourcing company employees increased from 68.55 to 89.75 points. The differences were statistically significant (P<0.05).Conclusion:HVA can be used to systematically risk-stratify potential threats, measure the probability of those potential hazards, and develop various hospital prevention and control measures for COVID-19 epidemics.

Analysis of Policies Based on the Multi-Fuzzy Regression Discontinuity, in Terms of the Number of Deaths in the Coronavirus Epidemic.

It has been a year since the outbreak of the coronavirus epidemic 2019 (COVID-19). In the face of the global epidemic, governments in all countries have taken different prevention measures, such as social isolation, mandatory health protection, and the closure of schools and workplaces. The situation of the epidemic has clearly varied from country to country. In this context, research on the impact of policies for the control of the spread of the global epidemic is of great significance. In this paper, we examined data from a sample of 212 countries between 31 December 2019, and 21 May 2020, using multi-fuzzy regression discontinuity. We found that developed countries had relatively low sensitivity to the policy stringency index; however, policy control measures had a significant effect on epidemic control. In addition, the trend analysis showed that the corresponding management and control came into play only after the policy stringency index reached 50 or the policy management reached level II, and the robustness was optimal at this time. Therefore, the governments in all countries should realize that epidemic prevention and control are of great importance. They can strengthen policy stringency to control the spread of the epidemic, considering their national conditions in terms of the economy and health system.

The 442th amino acid residue of the spike protein is critical for the adaptation to bat hosts for SARS-related coronaviruses

Bats carry diverse severe acute respiratory syndrome-related coronaviruses (SARSr-CoVs). The suspected interspecies transmission of SARSr-CoVs from bats to humans has caused two severe CoV pandemics, the SARS pandemic in 2003 and the recent COVID-19 pandemic. The receptor utilization of SARSr-CoV plays the key role in determining the host range and the interspecies transmission ability of the virus. Both SARS-CoV and SARS-CoV-2 use angiotensin-converting enzyme 2 (ACE2) as their receptor. Previous studies showed that WIV1 strain, the first living coronavirus isolated from bat using ACE2 as its receptor, is the prototype of SARS-CoV. The receptor-binding domain (RBD) in the spike protein (S) of SARS-CoV and WIV1 is responsible for ACE2 binding and medicates the viral entry. Comparing to SARS-CoV, WIV1 has three distinct amino acid residues (442, 472, and 487) in its RBD. This study aimed at exploring whether these three residues could alter the receptor utilization of SARSr-CoVs. We replaced the three residues in SARS-CoV (BJ01 strain) S with their counterparts in WIV1 S, and then evaluated the change of their utilization of bat, civet, and human ACE2s using a lentivirus-based pseudovirus infection system. To further validate the S-ACE2 interactions, the binding affinity between the RBDs of these S proteins and the three ACE2s were verified by flow cytometry. The results showed that the single amino acid substitution Y442S in the RBD of BJ01 S enhanced its utilization of bat ACE2 and its binding affinity to bat ACE2. On the contrary, the reverse substitution in WIV1 S (S442Y) significantly attenuated the pseudovirus utilization of bat, civet and human ACE2s for cell entry, and reduced its binding affinity with the three ACE2s. These results suggest that the S442 is critical for WIV1 adapting to bats as its natural hosts. These findings will enhance our understanding of host adaptations and cross-species infections of coronaviruses, contributing to the prediction and prevention of coronavirus epidemics.

Effects of the spread of COVID-19 on public health of polluted cities: results of the first wave forexplaining the dejà vu in the second wave of COVID-19pandemic and epidemics of future vital agents.

The pandemic of coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, is generating a high number of deaths worldwide. One of the current questions in the field of environmental science is to explain how air pollution can affect the impact of COVID-19 pandemic on public health. The research here focuses on a case study of Italy. Results suggest that the diffusion of COVID-19 in cities with high levels of air pollution is generating higher numbers of COVID-19 related infected individuals and deaths. In particular, results reveal that the number of infected people was higher in cities with more than 100 days per year exceeding limits set for PM10 or ozone, cities located in hinterland zones (i.e. away from the coast), cities having a low average speed of wind and cities with a lower average temperature. In hinterland cities having a high level of air pollution, coupled with low wind speed, the average number of infected people in April 2020—during the first wave of the COVID-19 pandemic—is more than tripled compared to cities with low levels of air pollution. In addition, results show that more than 75% of infected individuals and about 81% of deaths of the first wave of COVID-19 pandemic in Italy are in industrialized regions with high levels of air pollution. Although these vital results of the first wave of the COVID-19 from February to August 2020, policymakers have had a low organizational capacity to plan effective policy responses for crisis management to cope with COVID-19 pandemic that is generating recurring waves with again negative effects, déjà vu, on public health and of course economic systems.