Despite claims from prominent scientists that SARS‐CoV‐2 indubitably emerged naturally, the etiology of this novel coronavirus remains a pressing and open question: Without knowing the true nature of a disease, it is impossible for clinicians to appropriately shape their care, for policy‐makers to correctly gauge the nature and extent of the threat, and for the public to appropriately modify their behavior. Unless the intermediate host necessary for completing a natural zoonotic jump is identified, the dual‐use gain‐of‐function research (...) practice of viral serial passage should be considered a viable route by which the novel coronavirus arose. The practice of serial passage mimics a natural zoonotic jump, and offers explanations for SARS‐CoV‐2's distinctive spike‐protein region and its unexpectedly high affinity for angiotensin converting enzyme (ACE2), as well as the notable polybasic furin cleavage site within it. Additional molecular clues raise further questions, all of which warrant full investigation into the novel coronavirus's origins and a re‐examination of the risks and rewards of dual‐use gain‐of‐function research. (shrink)

Emergence of the novel pathogenic coronavirus SARS‐CoV‐2 and its rapid pandemic spread presents challenges that demand immediate attention. Here, we describe the development of a semi‐quantitative high‐content microscopy‐based assay for detection of three major classes (IgG, IgA, and IgM) of SARS‐CoV‐2 specific antibodies in human samples. The possibility to detect antibodies against the entire viral proteome together with a robust semi‐automated image analysis workflow resulted in specific, sensitive and unbiased assay that complements the portfolio of (...) class='Hi'>SARS‐CoV‐2 serological assays. Sensitive, specific and quantitative serological assays are urgently needed for a better understanding of humoral immune response against the virus as a basis for developing public health strategies to control viral spread. The procedure described here has been used for clinical studies and provides a general framework for the application of quantitative high‐throughput microscopy to rapidly develop serological assays for emerging virus infections. (shrink)

Since its emergence, the novel coronavirus disease of 2019 has had enormous physical, social, and psychological impacts worldwide. The aim of this article was to identify elements of our knowledge on asbestos exposure and malignant mesothelioma that can provide insight into the psychological impact of the COVID-19 pandemic and be used to develop adequate interventions. Although the etiology of Covid-19 and MM differs, their psychological impacts have common characteristics: in both diseases, there is a feeling of being exposed (...) through aerial contagion to an “invisible killer” without boundaries that can strike even the strongest individuals. In both cases, affected persons can experience personality dysfunction, anxiety, depression, and posttraumatic symptoms; helplessness, hopelessness, and projection of destructive thoughts onto external forces often emerge, while defense mechanisms such as denial, splitting, repression, and reduced emotional expression are used by individuals to contain their overwhelming anxieties. We believe that in both diseases, an integrated multidimensional intervention offered by hospitals and other public health services is the most effective approach to alleviating patients’ and caregivers’ psychological distress. In particular, we emphasize that in the context of both MM and COVID-19, Brief Psychoanalytic Group therapy can help patients and caregivers attribute meaning to the significant changes in their lives related to the experience of the disease and identify adaptive strategies and more realistic relational modalities to deal with what has happened to them. We also highlight the importance of developing a surveillance system that includes individual anamnestic evaluation of occupational risk factors for COVID-19 disease. (shrink)

The outbreak of the novel coronavirus pandemic, otherwise known as COVID-19 brought about the use of new terminologies—new lexical items such as social distancing, self-isolation, and lockdown. In developed countries, basic social amenities to support these are taken for granted; this is not the case in West African countries. Instead, those suggested safeguards against contracting COVID-19 have exposed the infrastructural deficit in West African countries. In addition, and more profoundly, these safeguards against the disease have distorted the traditional (...) community-individuality balance. The enforcement of social distancing, self-isolation, and lockdown has made it impossible for West Africans to drift to their ancestral homes and villages, as is usually the case in times of crisis, with attendant consequences for communal life and traditional burial rites. This could be one of the reasons why some COVID-19 patients are escaping from isolation centres, since to die in such centres violates their bodily integrity at an ontological level. (shrink)

Few novel or emerging infectious diseases have posed such vital ethical challenges so quickly and dramatically as the novel coronavirus SARS‐CoV‐2. The World Health Organization declared a public health emergency of international concern and recently classified Covid‐19 as a worldwide pandemic. As of this writing, the epidemic has not yet peaked in the United States, but community transmission is widespread. President Trump declared a national emergency as fifty governors declared state emergencies. In the coming weeks, hospitals (...) will become overrun, stretched to their capacities. When the health system becomes stretched beyond capacity, how can we ethically allocate scarce health goods and services? How can we ensure that marginalized populations can access the care they need? What ethical duties do we owe to vulnerable people separated from their families and communities? And how do we ethically and legally balance public health with civil liberties? (shrink)

ZusammenfassungDieser Beitrag ist Teil des Forums COVID-19: Perspektiven in den Geistes- und Sozialwissenschaften. Das neuartige Coronavirus stellt die Weltgemeinschaft vor eine große Herausforderung. Das Wissen über das Virus und seine Eigenschaften ist lückenhaft, aber der Bedarf, politische und medizinische Entscheidungen an wissenschaftlicher Erkenntnis auszurichten ist groß. Diese Lage führt zu einer Dynamisierung der Forschung. Ein prominentes Beispiel ist die WHO-Studie SOLIDARITY. Die epistemologischen Besonderheiten und die daraus resultierenden ethischen Implikationen werden in diesem Beitrag näher beleuchtet.This paper is part of (...) Forum COVID-19: Perspectives in the Humanities and Social Sciences. The novel coronavirus poses a huge challenge to the world community. Knowledge about the virus and its properties is limited, but there is a great need to base political and medical decisions on scientific knowledge. This situation is leading to a dynamization of research. A prominent example of such a development is SOLIDARITY. The epistemological dimensions of this trial, which is coordinated by the WHO, and the resulting ethical implications are discussed in this article. (shrink)

The novel coronavirus (SARS-CoV-2) pandemic has refocused attention on the issue of mandatory vaccination. Some have suggested that vaccines ought to be mandatory, while others propose more moderate alternatives, such as incentives. This piece surveys a range of possible interventions, ranging from mandates through to education. All may have their place, depending on circumstances. However, it is worth clarifying the options available to policymakers, since there is sometimes confusion over whether a particular policy constitutes a mandate or (...) not. Further, I illustrate a different kind of alternative to mandatory vaccination. Rather than seeking less coercive alternatives to a mandate, we might instead employ an alternative mandate, which requires people to do something less than get vaccinated. For instance, we might merely require people to attend an appointment at a vaccine clinic. Whether this mandatory attendance policy is justified will depend on specific circumstances, but it represents another way to promote vaccination, without mandating it. In some cases, this may represent an appropriate balance between promoting public health goals and respecting individual liberty. (shrink)

In times of crisis, one of the areas heavily affected has been food, as a direct consequence of the damage caused to family farming and therefore to Food and Nutrition Security (SAN). Climate change, in turn, causes widespread crises, which, due to their impact on humanity, and above all, on SAN, provide complex humanitarian crises, worsening hunger. The military conflict imposes difficulties in access to food and production. This study aimed to critically describe the panorama of climate change and armed (...) conflicts in Africa, relating them to the pandemic of COVID-19 as a factor of aggravating the situation of food insecurity in African countries. A literature review study was carried out in various databases, journals and portals for this purpose, with emphasis on Google Scholar, CAPES and governmental portals. The results point to climate change, as being multicausal, and constitute a risk factor for agriculture and SAN, in African countries, characterized by the destruction of crops and the reduction of food availability. Armed conflicts makes difficult to produce and distribute food, especially for people who’s affected. (shrink)

Severe acute respiratory syndrome‐coronavirus (SARS‐CoV)‐2′s origin is still controversial. Genomic analyses show SARS‐CoV‐2 likely to be chimeric, most of its sequence closest to bat CoV RaTG13, whereas its receptor binding domain (RBD) is almost identical to that of a pangolin CoV. Chimeric viruses can arise via natural recombination or human intervention. The furin cleavage site in the spike protein of SARS‐CoV‐2 confers to the virus the ability to cross species and tissue barriers, but was previously unseen (...) in other SARS‐like CoVs. Might genetic manipulations have been performed in order to evaluate pangolins as possible intermediate hosts for bat‐derived CoVs that were originally unable to bind to human receptors? Both cleavage site and specific RBD could result from site‐directed mutagenesis, a procedure that does not leave a trace. Considering the devastating impact of SARS‐CoV‐2 and importance of preventing future pandemics, researchers have a responsibility to carry out a thorough analysis of all possible SARS‐CoV‐2 origins. (shrink)

The pandemic of SARS-CoV-2 has led to unprecedented changes to society, causing unique problems that call for extraordinary solutions. We consider one such extraordinary proposal: ‘safer infection sites’ that would offer individuals the opportunity to be intentionally infected with SARS-CoV-2, isolate, and receive medical care until they are no longer infectious. Safer infection could have value for various groups of workers and students. Health professionals place themselves at risk of infection daily and extend this risk to their family (...) members and community. Similarly, other essential workers who face workplace exposure must continue their work, even if have high-risk household members and live in fear of infecting. When schools are kept closed because of the fear that they will be sites of significant transmission, children and their families are harmed in multiple ways and college students who are living on campus, whether or not they are attending classes in person, are contributing to high rates of transmission and experiencing high rates of exposure. We consider whether offering safer infection sites to these groups could be ethically defensible and identify the empirical unknowns that would need to resolve before reaching definitive conclusions. This article is not an endorsement of intentional infection with the coronavirus, but rather is meant to spark conversation on the ethics of out-of-the-box proposals. Perhaps most meaningfully, our paper explores the value of control and peace of mind for those among us most impacted by the pandemic: those essential workers risking the most to keep us safe. (shrink)

The world awaits a SARS-CoV-2 virus vaccine to keep the populace healthy, fully reopen their economies, and return their social and healthcare systems to “normal.” Vaccine safety and efficacy requires meticulous testing and oversight; this paper describes how despite grandiose public statements, the current vaccine development, testing, and production methods may prove to be ethically dubious, medically dangerous, and socially volatile. The basic moral concern is the potential danger to the health of human test subjects and, eventually, many vaccine (...) recipients. This is further complicated by economic and political pressures to reduce government oversight on rushed vaccine testing and production, nationalistic distribution goals, and failure to plan for the widespread immunization needed to produce global herd immunity. As this paper asserts, the public must be better informed to assess promises about the novel vaccines being produced and to tolerate delays and uncertainty. (shrink)

State authorities have taken a variety of measures aimed at combating the COVID-19 pandemic. One group of those measures constitutes restrictions on the freedom of economic activity. In the paper the author analyses the provisions establishing prohibitions on performing specific economic activities introduced in Poland in the period from 14 March 2020 to 31 May 2021 in order to verify whether they have sufficient legal bases. For that purpose it was necessary to establish the constitutional conditions for introducing restrictions on (...) the freedom of economic activity. Subsequently the author verified what legal bases for the implementation of the restrictions were indicated in the legal acts introducing those restrictions and how those prohibitions have been defined. The main research method used for the purpose of the paper is the dogmatic method of analysing the provisions contained in the legal acts. (shrink)

The COVID‐19 pandemic is responsible for millions of deaths worldwide yet its origin remains unclear. Two potential scenarios of how infection of humans initially occurred include zoonotic transfer from wild animals and a leak of the pathogen from a research laboratory. The Wuhan wet markets where wild animals are sold represent a strong scenario for zoonotic transfer. However, isolation of SARS‐CoV‐2 or its immediate predecessor from wild animals in their natural environment has yet to be documented. Due to incomplete (...) evidence for a zoonotic origin, a laboratory origin is plausible. The Wuhan Institute of Virology is at the epicenter of the pandemic and their work has included manipulation of wild‐type coronavirus to enable infection of human cells. Although stronger evidence supports the zoonotic transfer, inconclusive reports maintain the laboratory leak hypothesis alive. It is imperative to reach a factual conclusion to prevent future pandemics. (shrink)

Despite huge efforts towards understanding the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pathogenesis, little is known about the long‐term consequences of the disease. Here, we critically review existing literature about oncogenesis as a potential long‐term effect of SARS‐CoV‐2 infection. Like other viral infections, SARS‐CoV‐2 may promote cancer onset by inhibiting tumor suppressor genes. We conclude that, although unlikely, such hypothesis cannot be excluded a priori and we delineate an experimental approach to address it. Also see (...) the video abstract here: https://youtu.be/TBUTDSLR7vY. (shrink)

In 2019 a novel coronavirus, SARS-CoV-2, spread around the world and a global pandemic was declared early in 2020. Currently, the pandemic has still not been brought under control. Over time, many new words have seeped into ordinary language and old words have changed their meanings. In this article, I trace the semantic development of the word ‘endemic’ which spread from science discourse into political discourse and then into public discourse and became a euphemism. People are told (...) that they should now ‘live with’ the pandemic, a pandemic that is no longer dangerous, because it has turned endemic. This euphemistic use of ‘endemic’ has serious consequences for pandemic management and disease control, not only in countries like the UK, where the word has, indeed, become ‘endemic’, but around the world, as the word has the social function of concealing the circulation of the virus and normalising the spread of infection, even death. (shrink)

The origin of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is the subject of many hypotheses. One of them, proposed by Segreto and Deigin, assumes artificial chimeric construction of SARS‐CoV‐2 from a backbone of RaTG13‐like CoV and receptor binding domain (RBD) of a pangolin MP789‐like CoV, followed by serial cell or animal passage. Here we show that this hypothesis relies on incorrect or weak assumptions, and does not agree with the results of comparative genomics analysis. The genetic (...) divergence between SARS‐CoV‐2 and both its proposed ancestors is too high to have accumulated in a lab, given the timeframe of several years. Furthermore, comparative analysis of S‐protein gene sequences suggests that the RBD of SARS‐CoV‐2 probably represents an ancestral non‐recombinant variant. These and other arguments significantly weaken the hypothesis of a laboratory origin for SARS‐CoV‐2, while the hypothesis of a natural origin is consistent with all available genetic and experimental data. (shrink)

The causative agent of COVID‐19 SARS‐CoV‐2 has led to over 4 million deaths worldwide. Understanding the origin of this coronavirus is important for the prevention of future outbreaks. The dominant point of view that the virus transferred to humans either directly from bats or through an intermediate mammalian host has been challenged by Segreto and Deigin, who claim that the genome of SARS‐CoV‐2 has certain features suggestive of its artificial creation. Following their response to our commentary, here (...) we continue the discussion of the proposed arguments for this hypothesis. We show that neither the existence of a furin cleavage site in SARS‐CoV‐2, nor the presence of specific sequences within the nucleotide insertion encoding that site are evidence for intelligent design. We also explain why existing genetic data, viral diversity and past human history suggest that a natural origin of the virus is the most likely scenario. Genetic evidence suggesting otherwise is yet to be presented. (shrink)

Biocidal agents such as formaldehyde and glutaraldehyde are able to inactivate several coronaviruses including SARS‐CoV‐2. In this article, an insight into one mechanism for the inactivation of these viruses by those two agents is presented, based on analysis of previous observations during electron microscopic examination of several members of the orthocoronavirinae subfamily, including the new virus SARS‐CoV‐2. This inactivation is proposed to occur through Schiff base reaction‐induced conformational changes in the spike glycoprotein leading to its disruption or breakage, (...) which can prevent binding of the virus to cellular receptors. Also, a new prophylactic and therapeutic measure against SARS‐CoV‐2 using acetoacetate is proposed, suggesting that it could similarly break the viral spike through Schiff base reaction with lysines of the spike protein. This measure needs to be confirmed experimentally before consideration. In addition, a new line of research is proposed to help find a broad‐spectrum antivirus against several members of this subfamily. (shrink)

Viruses are the simplest of pathogens, but possess sophisticated molecular mechanisms to manipulate host behavior, frequently utilizing molecular mimicry. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to bind to the host receptor neuropilin-1 in order to gain entry into the cell. To do this, the virus utilizes its spike protein polybasic cleavage site (PCS), which mimics the CendR motif of neuropilin-1’s endogenous ligands. In addition to facilitating cell entry, binding to neuropilin-1 has analgesic effects. We (...) discuss the potential impact of neuropilin-1 binding by SARS-CoV-2 in ameliorating sickness behavior of the host, and identify a convergent evolutionary strategy of PCS cleavage and subsequent neuropilin binding in other human viruses. In addition, we discuss the evolutionary leap of the ancestor of SARS-COV-2, which involved acquisition of the PCS thus faciliting binding to the neuropilin-1 receptor. Acquisition of the PCS by the ancestor of SARS-CoV-2 appears to have led to pleiotropic beneficial effects including enhancement of cell entry via binding to ACE2, facilitation of cell entry via binding to neuropilin-1, promotion of analgesia, and potentially the formation of decoy epitopes via enhanced shedding of the S1 subunit. Lastly, other potential neuromanipulation strategies employed by SARS-CoV-2 are discussed, including interferon suppression and the resulting reduction in sickness behavior, enhanced transmission through neurally mediated cough induction, and reduction in sense of smell. (shrink)

We explore the ethics of deliberately exposing consenting adults to SARS-CoV-2 to induce immunity to the virus (“DEI” for short). We explain what a responsible DEI program might look like. We explore a consequentialist argument for DEI according to which DEI is a viable harm-reduction strategy. Then we consider a non-consequentialist argument for DEI that draws on the moral significance of consent. Additionally, we consider arguments for the view that DEI is unethical on the grounds that, given that large-scale (...) DEI would be highly likely to result in some severe illnesses and deaths, DEI amounts to a form of killing. Our thesis is that incorporating a DEI program alongside the status-quo “calibrate-the-curve” responses could have significant advantages at the early stages of pandemics. These potential advantages mean that, at a minimum, research into DEI would have been justified early in the COVID-19 pandemic, and that DEI programs should be explored as potential additions to our overall approach to emerging pandemics in the future. (shrink)

Drawing on original ethnobotanical and anthropological research among Indigenous peoples across the Amazon, we examine synergies and dissonances between Indigenous and Western scientific knowledge about the environment, resource use, and sustainability. By focusing on the sensory dimension of Indigenous engagements with the environment—an approach we have described as “sensory ecology” and explored through the method of “phytoethnography”—we promote a symmetrical dialogue between Indigenous and scientific understandings around such phenomena as animal–plant mutualisms, phytochemical toxicity, sustainable forest management in “multinatural” landscapes, and (...) the emergence of new diseases like the novel coronavirus SARS-CoV-2 (COVID-19). Drawing examples from our own and other published works, we explore the possibilities and limitations of a “parallax view” attempting to hold Indigenous and scientific knowledge in focus simultaneously. As the concept of “bioeconomy” emerges as a key alternative for sustainable development of the Amazon, we encourage a critical and urgent engagement between dominant Western conceptions and Indigenous Amazonian knowledge, practices, and cultural values. Cognitive science, which has long contributed to studies of Indigenous categorization and conceptualization of the natural world, continues to play an important role in building bridges of mutual communication and respect between Indigenous and scientific approaches to sustainability and biodiversity conservation. (shrink)

A number of papers have appeared recently arguing for the conclusion that it is ethically acceptable to infect healthy volunteers with severe acute respiratory syndrome coronavirus 2 as part of research projects aimed at developing COVID-19 vaccines or treatments. This position has also been endorsed in a statement by a working group for the WHO. The papers generally argue that controlled human infection is ethically acceptable if the risks to participants are low and therefore acceptable, the scientific quality of (...) the research is high, the research has high social value, participants give full informed consent, and there is fair selection of participants. All five conditions are necessary premises in the overall argument that such research is ethically acceptable. The arguments concerning risk and informed consent have already been critically discussed in the literature. This paper therefore looks specifically at the arguments relating to condition 3 ‘high social value’ and condition 5 ‘fair selection of participants’ and shows that whereas they may be valid, they are not sound. It is highly unlikely that the conditions that are necessary for ethical CHI trials to take place will be fulfilled. Most, if not all, CHI trials will thus be well intentioned but unethical. (shrink)

The first clinical symptoms focused on the presentation of coronavirus disease 2019 have been respiratory failure, however, accumulating evidence also points to its presentation with neuropsychiatric symptoms, the exact mechanisms of which are not well known. By using a computational methodology, we aimed to explain the molecular paths of COVID-19 associated neuropsychiatric symptoms, based on the mimicry of the human protein interactions with SARS-CoV-2 proteins.Methods: Available 11 of the 29 SARS-CoV-2 proteins’ structures have been extracted from Protein (...) Data Bank. HMI-PRED, a recently developed web server for structural PREDiction of protein-protein interactions between host and any microbial species, was used to find the “interface mimicry” through which the microbial proteins hijack host binding surfaces. Classification of the found interactions was conducted using the PANTHER Classification System.Results: Predicted Human-SARS-CoV-2 protein interactions have been extensively compared with the literature. Based on the analysis of the molecular functions, cellular localizations and pathways related to human proteins, SARS-CoV-2 proteins are found to possibly interact with human proteins linked to synaptic vesicle trafficking, endocytosis, axonal transport, neurotransmission, growth factors, mitochondrial and blood-brain barrier elements, in addition to its peripheral interactions with proteins linked to thrombosis, inflammation and metabolic control.Conclusion: SARS-CoV-2-human protein interactions may lead to the development of delirium, psychosis, seizures, encephalitis, stroke, sensory impairments, peripheral nerve diseases, and autoimmune disorders. Our findings are also supported by the previous in vivo and in vitro studies from other viruses. Further in vivo and in vitro studies using the proteins that are pointed here, could pave new targets both for avoiding and reversing neuropsychiatric presentations. (shrink)

Prestigious University is a large, private educational institution with a medical school, a university hospital, a law school, and graduate and undergraduate colleges all on a single campus. In the face of the Covid‐19 pandemic, students were told during spring break to return to campus only briefly to retrieve their belongings. Classes then went online. On March 23, 2020, the faculty, students, and staff were emailed the following by the university's director of infection control and public health: We have become (...) aware that a Prestigious University staff member has tested positive for the virus that causes Covid‐19. The individual, who was last on campus on March 16, is now in isolation at their permanent residence and is doing well clinically. The university has already identified those members of our community who may have been in close contact with this individual, and we are working to notify them. Further, this individual's local health department has a protocol for identifying people who have been in direct contact with anyone testing positive for Covid‐19 (such as this Prestigious University staff member) so that they can self‐quarantine and watch for COVID‐19 symptoms for a period of 14 days from their last contact with the infected individual.A professor in the Philosophy Department has asked the ethicists at the medical school whether such contact tracing suffices. “Don't the members of the community deserve to know who this is? Isn't there a mandate to identify this person in order to maximize public health benefits and slow the spread of this deadly virus?”. (shrink)

The coronavirus pandemic has necessitated extraordinary human resilience in order to preserve and prolong life and social order. Risks to health and even life are being confronted by workers in health and social care, as well as those in roles previously never defined as “frontline,” such as individuals working in community supply chain sectors. The strategy adopted by the United Kingdom government in facing the challenges of the pandemic was markedly different from other countries. The present study set out (...) to examine what variables were associated with resilience, burnout, and wellbeing in all sectors of frontline workers, and whether or not these differed between the UK and Republic of Ireland. Individuals were eligible if they were a frontline worker in the UK or RoI during the pandemic. Part of a larger, longitudinal study, the participants completed an online survey to assess various aspects of their daily and working lives, along with their attitudes toward their government’s handling of the crisis, and measurement of psychological variables associated with heroism. A total of 1,305 participants provided sufficient data for analysis. UK-based workers reported lower wellbeing than the RoI-based participants. In multivariate models, both psychological and pandemic-related variables were associated with levels of resilience, burnout, and wellbeing in these workers, but which pandemic-related variables were associated with outcomes differed depending on the country. The judgment of lower timeliness in their government’s response to the pandemic appeared to be a key driver of each outcome for the UK-based frontline workers. These findings provide initial evidence that the different strategies adopted by each country may be associated with the overall wellbeing of frontline workers, with higher detriment observed in the UK. The judgment of the relatively slow response of the UK government to instigate their pandemic measures appears to be associated with lower resilience, higher burnout, and lower wellbeing in frontline workers in the UK. (shrink)

The emergent Coronavirus Disease 2019 caused by the Severe Acute Respiratory Syndrome Coronavirus 2 could produce a maternal immune activation via the inflammatory response during gestation that may impair fetal neurodevelopment and lead to postnatal and adulthood mental illness and behavioral dysfunctions. However, so far, limited evidence exists regarding long-term physiological, immunological, and neurodevelopmental modifications produced by the SARS-CoV-2 in the human maternal-fetal binomial and, particularly, in the offspring. Relevant findings derived from epidemiological and preclinical models show (...) that a MIA is indeed linked to an increased risk of neurodevelopmental disorders in the offspring. We hypothesize that a gestational infection triggered by SARS-CoV-2 increases the risks leading to neurodevelopmental disorders of the newborn, which can affect childhood and the long-term quality of life. In particular, disruption of either the maternal or the fetal cholinergic anti-inflammatory pathway could cause or exacerbate the severity of COVID-19 in the maternal-fetal binomial. From a translational perspective, in this paper, we discuss the possible manifestation of a MIA by SARS-CoV-2 and the subsequent neurodevelopmental disorders considering the role of the fetal-maternal cytokine cross-talk and the CAP. Specifically, we highlight the urgent need of preclinical studies as well as multicenter and international databanks of maternal-fetal psychophysiological data obtained pre-, during, and post-infection by SARS-CoV-2 from pregnant women and their offspring. (shrink)

The recent changes in COVID-19 symptoms suggest convergent evolution of respiratory diseases. This process is analogous to the emergence of animal mimetic complexes and complements previously identified types of mimicry. A novel pathogen might go unnoticed or insufficiently counteracted if it resembles a disease that the host already faced on multiple occasions, which creates a selective pressure towards a typical symptomic phonotype. In short, the reason why so many unrelated pathogens cause similar symptoms may correspond to the reasons that (...) drove the evolution of the ‘warning’ wasp-like colouration in various insect species. (shrink)

As I organize a pile of ethics consult chart notes in New York City in mid‐April 2020, I look at the ten cases that I have co‐consulted on recently. Nine of the patients were found to be Covid positive. The reasons for the consults are mostly familiar—surrogate decision‐making, informed refusal of treatment, goals of care, defining futility. But the context is unfamiliar and unsettling. Bioethicists are in pandemic mode, dusting off and revising triage plans. Patients and potential patients are fearful—of (...) the disease itself and of the amplification of health disparities and inequities. There is much to contemplate, but as I go through my cases, I worry about disability, about biases and racist stereotypes. In this pandemic, historically marginalized communities are at risk of further disenfranchisement. (shrink)

ObjectiveThe study is an explorative investigation aimed to assess the differences in acute stress response patterns of health workers facing coronavirus disease 2019 (COVID-19) during Italy’s first lockdown.MethodsA cross-sectional investigation using convenience sampling method was conducted in Italy during April 2020. Eight hundred fifty-eight health workers participated in the research filling out self-report measures including Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), and Impact of Event Scale–Revised (IES-R).ResultsModerate/severe depression was found in 28.9% (95% CI, (...) 25.8–32.04), moderate/severe anxiety in 55.4% (95% CI, 51.9–58.8), insomnia in 15% (95% CI, 12.5–17.5), and distress in 52.5% (95% CI, 48.5%–56.6) of participants. The 3% of health workers reported frequent suicidal thoughts. Female sex, working for >15 h/week in a COVID-19 unit, and living apart from family were associated with a significantly higher risk of distress, anxiety, insomnia, depression, and functional impairment. Four profiles were identified on the basis of psychopathological measures: Profile_0 included 44% (N= 270); Profile_1, 25.6% (N= 157); Profile_2, 19.1% (N= 117); and Profile_3, 11.3% (N= 69) of participants. Results showed a significant effect for Profiles X IES-R (η2= 0.079;f= 0.29), indicating that in all profiles, except for Profile_0, avoidance scale is lower than hyperarousal and intrusion symptoms scales of the IES-R. This characteristic could be a probable index of the control exerted by the responders to not fly away from their job.ConclusionThe identification of specific profiles could help psychiatrists and emergency psychologists to build specific interventions in terms of both primary and secondary prevention to face future waves of the COVID-19 outbreak. (shrink)

ObjectiveTo investigate the association of pre-existing migraine in patients hospitalised and who recovered from severe acute respiratory syndrome coronavirus 2 infection with the presence of post-coronavirus disease symptoms.BackgroundNo study has investigated the role of migraine as a risk factor for development of post-COVID symptoms.MethodsA case-control study including individuals hospitalised during the first wave of the pandemic was conducted. Patients with confirmed previous diagnosis of migraine were considered cases. Two age- and sex-matched individuals without a history of headache per (...) case were also recruited as controls. Hospitalisation/clinical data were collected from hospital medical records. Patients were scheduled for a telephone interview. A list of post-COVID symptoms was systematically evaluated, but participants were invited to freely report any symptom. The Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index were used to assess anxiety/depressive symptoms and sleep quality. Multivariable conditional logistic regression models were constructed.ResultsOverall, 57 patients with confirmed diagnosis of migraine and 144 non-migraine controls who had recovered from COVID-19 were assessed at 7.3 months after hospital discharge. The number of post-COVID symptoms in the migraine group was significantly greater than in the non-migraine group. Fatigue was significantly more prevalent in the migraine group. However, no between-groups difference in the prevalence of headache as a post-COVID symptom was detected.ConclusionPatients with a history of migraine who recovered from COVID-19 exhibited more long-term fatigue as post-COVID sequelae than those without migraine. Some of the pathophysiological changes associated with migraine could predispose to the occurrence of post-COVID symptoms. (shrink)

COVID‐19, caused by a novel coronavirus named SARS‐CoV‐2, was identified in December 2019, in Wuhan, China. It was first confirmed in sub‐Saharan Africa in Nigeria on 27 February 2020 and has since spread quickly to all sub‐Saharan African countries, causing more than 111,309 confirmed cases and 2,498 deaths as of 03 June 2020. The lessons learned during the recent Ebola virus disease (EVD) outbreaks in some sub‐Saharan African countries were expected to shape and influence the region’s responses (...) to COVID‐19 pandemic. However, some of the challenges associated with the management of the EVD outbreaks persist and create obstacles for the effective management of the COVID‐19 pandemic. This article describes the commonalities between the EVD epidemics and COVID‐19 pandemic, with a view to draw on lessons learned to effectively tackle the ongoing pandemic. Key successes, failures and lessons learned from previous EVD outbreaks are discussed. Recommendations on how these lessons can be translated to strengthen the COVID‐19 response in sub‐Saharan Africa are provided. (shrink)

Currently whole world is facing immense crisis caused by the unprecedented pandemic coronavirus disease 2019 (COVID-19). This pandemic with its unique features has raised distinct ethical issues and the whole scenario has altered according to its pressing novel features. This paper aims to analyze the emerging ethical issues raised by the recent worldwide pandemic outbreak of SARS-COV-2. I have differentiated and analyzed the unprecedented emerging ethical issues from three aspects. First, there are ethical issues which arise due (...) to the sudden imposition of preventive measures such as isolation, quarantine, and social distancing by public health authorities. It is indeed problematic to suddenly adopt the ‘new normal’ in our usual social life. Secondly, there are moral dilemmas which occur when physicians and health care workers try to maintain just allocation of the limited medications to treat large number of patients. Finally, the challenge of policy makers on the effective implementation of the policies that gain trust from people. Here, the role of administrative policy makers is to recognize the moral values in decision-making within the ethically challenging situations when the usual approved behaviors are dangerous to others. I analyze the importance of the virtue of solidarity, benevolence, honesty, and equity to deal with this crisis. (shrink)

The ongoing global pandemic of Covid-19 has exposed SARS-CoV-2 as a potent non-human actant that resists the joint scientific, public health and socio-political efforts to contain and understand both the virus and the illness. Yet, such a narrative appears to conceal more than it reveals. The seeming agentiality of the novel coronavirus is itself but one manifestation of the continuous destruction of biodiversity, climate change, socio-economic inequalities, neocolonialism, overconsumption and the anthropogenic degradation of nature. Furthermore, focusing on (...) the virus – an entity that holds an ambiguous status between the ‘living’ and ‘non-living’ – brings into question the issue of the agentiality of non/living matter. While the story of viral potency seems to get centre stage, overshadowing the complex and perverse entanglement of processes and phenomena which activated these potentials in the first place, the Covid-19 pandemic also becomes a prism that sheds light on the issues of environmental violence; social and environmental injustices; more-than-human agentiality; and ethico-political responses that the present situation may mobilise. -/- This article serves as a written record of joint conversations between artists and researchers in the working group ‘Non/Living Queerings’ that formed part of the online series of events ‘Braiding Friction’ organised by the research project Biofriction. The article strives to capture the collective effort of braiding and weaving a variety of situated perspectives, theoretical toolboxes, knowledges and experiences against the background of the ongoing Covid-19 pandemic. In particular, the text focuses on the issues of crisis, ‘amplification effect’, viral agency and the changing notions of humanity. (shrink)

En este trabajo se examinan los escenarios sociales planteados por la pandemia de coronavirus desde la perspectiva de la Teoría de sistemas sociales. La indagación se realiza en dos pasos: en el primero de ellos, en diálogo con la virología, la epidemiología y la demografía, se analiza la forma comunicativa amenazante del virus SARS-CoV-2 y de la enfermedad COVID-19 así como su evolución en el tiempo mediante la distinción riesgo/peligro; y en el segundo paso, se observa la dinámica (...) de las interacciones, las organizaciones, los sistemas de protesta y de la sociedad mundial, enfocando algunos de sus sistemas funcionales como la religión, la política, la salud y la economía. (shrink)

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at (...) this time, for 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

The COVID-19 pandemic prompted immense work on the investigation of the SARS-CoV-2 virus. Ontologies – structured, controlled, vocabularies – are designed to support consistency of interpretation, and thereby to prevent the development of data silos. This paper describes how ontologies are serving this purpose in the virus research domain, following the principles of the Open Biological and Biomedical Ontology (OBO) Foundry and drawing on the resources of the Infectious Disease Ontology (IDO) Core. We report the development of the Virus (...) Infectious Disease Ontology (VIDO), a reference ontology extending IDO Core covering viral infectious diseases. We examine newly minted terms, showcase ontology term reuse, and illustrate the use of VIDO by annotating selections from recent life science research on SAR-CoV-2, in the interest of supporting machine learning projects. (shrink)

Vietnam, with a geographical proximity and a high volume of trade with China, was the first country to record an outbreak of the new Coronavirus disease (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 or SARS-CoV-2. While the country was expected to have a high risk of transmission, as of April 4, 2020—in comparison to attempts to contain the disease around the world—responses from Vietnam are being seen as prompt and effective in protecting the interests (...) of its citizens, with 239 confirmed cases and no fatalities. This study analyzes the situation in terms of Vietnam’s policy response, social media and science journalism. A self-made web crawl engine was used to scan and collect official media news related to COVID-19 between the beginning of January and April 4, yielding a comprehensive dataset of 14,952 news items. The findings shed light on how Vietnam—despite being under-resourced—has demonstrated political readiness to combat the emerging pandemic since the earliest days. Timely communication on any developments of the outbreak from the government and the media, combined with up-to-date research on the new virus by the Vietnamese science community, have altogether provided reliable sources of information. By emphasizing the need for immediate and genuine cooperation between government, civil society and private individuals, the case study offers valuable lessons for other nations concerning not only the concurrent fight against the COVID-19 pandemic but also the overall responses to a public health crisis. (shrink)

COVID-19 poses an exceptional threat to global public health and well-being. Recognition of the need to develop effective vaccines at unprecedented speed has led to calls to accelerate research pathways ethically, including by conducting challenge studies ) with SARS-CoV-2. Such research is controversial, with concerns being raised about the social, legal, ethical and clinical implications of infecting healthy volunteers with SARS-CoV-2 for research purposes. Systematic risk evaluations are critical to inform assessments of the ethics of any proposed (...) class='Hi'>SARS-CoV-2 CHIs. Such evaluations will necessarily take place within a rapidly changing and at times contested epidemiological landscape, in which differing criteria for the ethical acceptability of research risks have been proposed. This paper critically reviews two such criteria and evaluates whether the use of effective treatment should be a necessary condition for the ethical acceptability of SARS-CoV-2 CHIs, and whether the choice of study sites should be influenced by COVID-19 incidence levels. The paper concludes that ethical evaluations of proposed SARS-CoV-2 CHIs should be informed by rigorous, consultative and holistic approaches to systematic risk assessment. (shrink)

El artículo plantea condiciones clínico-epidemiológicas peculiares cuando la humanidad se enfrente a una zoonosis emergente. El ejemplo que groseramente ha golpeado a la humanidad es la pandemia de Covid-19, enfermedad causada por el coronavirus SARS-CoV-2. Si bien la historia de la humanidad da cuenta de múltiples pandemias ocasionadas por varios agentes infectocontagiosos, es cierto que en el primer momento de afrontar una problemática global de esta naturaleza lo que prima es la incertidumbre. Ante ella, existe la obligación moral (...) de proveer los mejores servicios de salud que sea posible; a la par, debe realizarse una investigación para encontrar medidas farmacéuticas específicas que contengan y mitiguen el daño poblacional (medicamentos específicos y/o vacunas). Mientras tanto, sabiendo que en el caso de la actual pandemia de Covid-19 la principal y más eficiente vía de transmisión es la propagación por gotas de saliva, el distanciamiento físico es crucial. Una consulta médica involucra hablar en el interrogatorio y una proximidad física durante la exploración. Existen datos que indican que la telemedicina tiene un alto grado de recomendación para la protección de la salud, tanto de profesionales como de pacientes. Se recuerda que una declaración de la Asociación Médica Mundial ha tratado el tema de la telemedicina; con su exposición, se indican alcances, limitaciones y proyecciones en el futuro. (shrink)

El SARS-CoV-2 más conocido como COVID 19 ha evidenciado de forma radical como el sistema capitalista neoliberal, nos ha llevado a una serie de maquillajes de la realidad que no permitían ver la gravedad de su construcción de inequidad, pero lo que es peor, al convertir en una empresa rentable todo lo que toca, termino por desdibujar la democracia, la justicia, y el estado mismo. El presente texto que obedece al programa de investigación “proyecto 29-000029 Dinámicas urbano-regionales, economía solidaria (...) y construcción de paz territorial en Antioquia” de UNAULA, para demostrar lo inicialmente planteado se procederá primero mostrando como el sistema de salud al ser convertido en un negocio, no tuvo capacidad para enfrentar la pandemia en ninguna parte del mundo, ello tuvo como consecuencia la parálisis de la economía mundial, pero adicionalmente genero un escenario perfecto para el encumbramiento de dictadores disfrazados de mesías, bien sea por el temor de los parlamentos a enfermarse o su cierre simbólico por su ausencia, eliminando de tajo la escasa democracia representativa, sumado a la parálisis de la justicia, además de la pobreza, el racismo, desigualdad y la estigmatización, que se vio controlada por la represión armada y la vigilancia que reino en el mundo y especialmente en Colombia con diferentes facetas. (shrink)

The spread of the coronavirus SARS-CoV-2 has stimulated eschatological speculation. To the environmentalist and liberal diagnostician that had already been warning about the Anthropocene and the breakdown of post-Cold War global harmony, an alarm has now been added that in its worst prognosis estimates that, in 2020, we only started witnessing the beginning of a staggered health debacle. The idea of the world, as conceptual support for an imaginary community with global reach, has become a crisis. The world, (...) an object often invoked by theoretical speculation over the last 30 years, has been now decreed finished. However, infectious diseases, in their epidemic and pandemic form, have devastated different societies at different times. This paper parallels two historical scenarios and a series of texts dealing with contagious diseases to shed light on the idea of (the end of) the world. The analysis centres on documents that bear witness to the importation of smallpox and other diseases into America and its spread during the European invasion and colonization. By recovering the concept of Pachakuti, a radical turnaround that can be understood as “end of one world”, this paper shows that the chronicles reporting on the outbreaks of smallpox in America document a material end of the world for subjects who were not protagonists of history. The current end of the world is, on the contrary, that which would correspond to the protagonist of our phase of globalization and, eventually, to _his_ world—which makes it more resonant and absolute. (shrink)

The coronavirus (SARS-CoV-2) is the latest but not the first deadly pathogen to jump from animals to humans. The history of pandemics is replete with such events. The convergence of animal health, human health, and ecosystem health is a twenty-first century reality, as human activities that drive climate change also contribute to pandemic risk. Understanding the past and future of zoonotic diseases requires new models in the way we research human-animal-environment interconnections. This bibliographic essay discusses the historical development (...) of these zoonotic diseases and incorporates sources from the history of science and medicine, environmental science, animal science, disease ecology, politics, and anthropology. Contributing to deeper understandings of zoonotic diseases, historians and anthropologists have viewed pandemics as social and biological phenomena. However, viewpoints differ whether scholars routinely examine disease links between animals and humans. These links include the ecological aspects of infectious diseases' history and the role of wildlife as vectors of zoonotic disease. In addition, challenges persist in integrating social sciences and humanities, the environmental sector, and scientific research. Ideally, historiographies of zoonotic diseases would include societies’ responses and the social, cultural, political, economic, and ecological contexts. This bibliographic essay assembles resources that would benefit such an integrated approach. (shrink)

Immunity against SARS‐CoV‐2 that is acquired by convalescent COVID‐19 patients is examined in reference to (A) the Th17 cell generation system in psoriatic epidermis and (B) a recently discovered phenomenon in which Th17 cells are converted into tissue‐resident memory T (TRM) cells with Th1 phenotype. Neutrophils that are attracted to the site of infection secrete IL‐17A, which stimulates lung epithelial cells to express CCL20. Natural Th17 (nTh17) cells are recruited to the infection site by CCL20 and expand in the (...) presence of IL‐23. These nTh17 cells are converted to TRM cells upon encounter with SARS‐CoV‐2 and continue to exist as ex‐Th17 cells, which exert Th1‐like immunity during a memory response. G‐CSF can induce nTh17 cell accumulation at the infection site because it promotes neutrophil egress from the bone marrow. Hence, G‐CSF may be effective against COVID‐19. Administration of G‐CSF to patients infected with SARS‐CoV‐2 is worth a clinical trial. (shrink)

The 2019 coronavirus (COVID‐19), also known as SARS‐CoV‐2, is highly pathogenic and virulent, and it spreads very quickly through human‐to‐human contact. In response to the growing number of cases, governments across the spectrum of affected countries have adopted different strategies in implementing control measures, in a hope to reduce the number of new cases. However, 5 months after the first confirmed case, countries like the United States of America (US) seems to be heading towards a trajectory that indicates (...) a health care crisis. This is in stark contrast to the downward trajectory in Europe, China, and elsewhere in Asia, where the number of new cases has seen a decline ahead of an anticipated second wave. A data‐driven approach reveals three key strategies in tackling COVID‐19. Our work here has definitively evaluated these strategies and serves as a warning to the US, and more importantly, a guide for tackling future pandemics. Also see the video abstract here https://youtu.be/gPkCi2_7tWo. (shrink)

RaTG13, MP789, and RmYN02 are the strains closest to SARS‐CoV‐2, and their existence came to light only after the start of the pandemic. Their genomes have been used to support a natural origin of SARS‐CoV‐2 but after a close examination all of them exhibit several issues. We specifically address the presence in RmYN02 and closely related RacCSxxx strains of a claimed natural PAA/PVA amino acid insertion at the S1/S2 junction of their spike protein at the same position where (...) the PRRA insertion in SARS‐CoV‐2 has created a polybasic furin cleavage site. We show that RmYN02/RacCSxxx instead of the claimed insertion carry a 6‐nucleotide deletion in the region and that the 12‐nucleotide insertion in SARS‐CoV‐2 remains unique among Sarbecoviruses. Also, our analysis of RaTG13 and RmYN02's metagenomic datasets found unexpected reads which could indicate possible contamination. Because of their importance to inferring SARS‐CoV‐2′s origin, we call for a careful reevaluation of RaTG13, MP789 and RmYN02 sequencing records and assembly methods. (shrink)

While spreading wide-world, the new coronavirus Sars-CoV-2 made changes in many social departments of our society on levels we never thought about and messes with all our cultural habits. Thus, we witnessed that the religious denominations took into consideration changes without precedent in their cultic history and thus dogmatic as well concerning the actual threat of Coronavirus. We saw for example the Roman-Catholic Church who suspended all masses here and there[1] at first or banned the crucial gestures (...) in rituals [to suspend the distribution of Holy Communion from the Chalice[2], to distribute the Eucharist preferably into the hands of the faithful, and to avoid the physical contact from a peaceful handshake, to forego ash crosses on forehead, to suspend placing water in holy water fonts at the entrance of churches, that the churchgoers "refrain" from kissing or touching the cross for veneration, or even cancellation of masses]. We witnessed Buddhist temples and Protestant churches around Korea [at first] and beyond that have also suspended religious gatherings, and so on. In my case, the Romanian Orthodox Church did the same thing[3], but in a controversial way, firstly making some recommendations for its believers [e.g. not to kiss public icons in Churches, but their indoor ones, and receive Holy Communion with teaspoons for single-use]; afterward same Church reconsidered these recommendations and withdrew its decision [perhaps at the pressure of civil fundamentalists]. How can we qualify all these measures and, moreover, the withdrawal on behalf of religious believers, as weakness, populism, diligence, assuming the human limits, or...something else? What would be the correct and coherent answer religion should assume in this particular regard, and especially what are the reasons to qualify it in a way or another? (shrink)

In December 2019, the city of Wuhan in Hubei became the epicenter of an unprecedented health crisis. SARS-CoV-2 is marking a watershed moment for sapiens. On the one hand, we are facing the most serious health emergency of the 21st century, on the other hand we are beginning to experience the negative effects of our development models that do not take into account the welfare of non-human animals and the systemic effect that our actions have on the balance of (...) the biosphere. In the contributions hosted in this Dossier, the plurality of issues raised by SARS-CoV-2 comes to light clearly and distinctly. From bioethical questions to biopolitical issues, including an in-depth examination of the effects that the pandemic is having on society and on the capacity for self-perception of sapiens, we try to shed light on the countless consequences that this pandemic is bringing with it. (shrink)

In the throes of the COVID-19 pandemic three major transplant societies jointly issued a statement strongly recommending that all eligible transplant candidates receive a COVID-19 vaccine that is a...

More than 15 million people have been affected by coronavirus disease 2019 (COVID‐19) and it has caused 640 016 deaths as of July 26, 2020. Currently, no effective treatment option is available for COVID‐19 patients. Though many drugs have been proposed, none of them has shown particular efficacy in clinical trials. In this article, the relationship between the Adrenergic system and the renin‐angiotensin‐aldosterone system (RAAS) is focused in COVID‐19 and a vicious circle consisting of the Adrenergic system‐RAAS‐Angiotensin converting enzyme (...) 2 (ACE2)‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) (which is referred to as the “ARAS loop”) is proposed. Hyperactivation of the ARAS loop may be the underlying pathophysiological mechanism in COVID‐19, and beta‐adrenergic blockers are proposed as a potential treatment option. Beta‐adrenergic blockers may decrease the SARS‐CoV‐2 cellular entry by decreasing ACE2 receptors expression and cluster of differentiation 147 (CD147) in various cells in the body. Beta‐adrenergic blockers may decrease the morbidity and mortality in COVID‐19 patients by preventing or reducing acute respiratory distress syndrome (ARDS) and other complications. Retrospective and prospective clinical trials should be conducted to check the validity of the hypothesis. Also see the video abstract here https://youtu.be/uLoy7do5ROo. (shrink)