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Download Preprint 1 2 Parallel pandemics illustrate the need for One Health solutions 3 4 Authors: Claire Tucker1, Anna Fagre1, George Wittemyer2, Tracy Webb3, Edward Okoth 5 Abworo4, Sue VandeWoude*5 6 7 8 1Department of Microbiology, Immunology, Pathology. College of Veterinary Medicine and 9 Biomedical Sciences. Colorado State University. Fort Collins, Colorado; 2 Department of Fish, 10 Wildlife, and Conservation Biology. Warner College of Natural Resources. Colorado State 11 University. Fort Collins, Colorado; 3 Department of Clinical Sciences. College of Veterinary 12 Medicine and Biomedical Sciences. Colorado State University. Fort Collins, Colorado; 13 4International Livestock Research Institute. Nairobi, Kenya; 5 Corresponding Author: Sue 14 VandeWoude, DVM, PhD, Department of Microbiology, Immunology, Pathology. College of 15 Veterinary Medicine and Biomedical Sciences. Colorado State University. Fort Collins, 16 Colorado. [email protected]. https://orcid.org/0000-0001-9227-1622. 17 18 19 20 21 22 23 24 1 25 Abstract 26 African Swine Fever (ASF) was reported in domestic pigs in China in 2018. This highly 27 contagious viral infection with no effective vaccine reached pandemic proportions by 2019, 28 substantially impacting protein availability in the same region where the COVID-19 pandemic 29 subsequently emerged. We discuss the genesis, spread, and wide-reaching impacts of an 30 epidemic in a vital livestock species, noting parallels and potential contributions to ignition of 31 COVID-19. We speculate about follow-on impacts of these pandemics on global public health 32 infrastructure and suggest intervention strategies using a cost: benefit approach for low-risk, 33 massive-impact events. We note that substantive changes in how the world reacts to potential 34 threats will be required to overcome catastrophes driven by climate change, food insecurity, lack 35 of surveillance infrastructure and other gaps. We note that a One Health approach creating 36 collaborative processes connecting expertise in human, animal, and environmental health is 37 essential for combating future global health crises. 2 1 Introduction 2 “One Health” is a recently coined, emblematic phrase representing a holistic approach to health 3 care that defies simple definition and thus suffers from its inability to be easily comprehended. 4 The Centers for Disease Control and Prevention (CDC), the One Health Commission, the 5 United States Department of Agriculture (USDA), and the National Institutes of Health (NIH) 6 define One Health as an approach, involving health of humans, animals (domestic and wild), 7 and the environment (ecosystem, sometimes plants), and involving a wide lens and 8 transdisciplinary effort1. The One Health Initiative Task Force, convened in 2008 by the 9 American Veterinary Medical Association (AVMA), perhaps defines One Health most succinctly 10 as: "the collaborative efforts of multiple disciplines working locally, nationally, and globally, to 11 attain optimal health for people, animals and our environment"2. 12 13 COVID-19 caused by SARS-CoV-2 is a putative zoonosis that emerged and spread globally 14 within a matter of months. The COVID-19 pandemic is the most severe One Health crisis of our 15 time. Examining the reasons underlying the emergence of SARS-CoV-2, its epidemic spread, 16 effective ways to control the virus, and all the unforeseen consequences of COVID-19 will 17 occupy pundits for decades. But SARS-CoV-2 did not emerge in a vacuum. A second pandemic 18 caused by African Swine Fever (ASF) emerged in domestic swine populations in China just prior 19 to COVID-19, spreading to Mongolia, Vietnam, and Eastern Europe by mid-2019. The ASF 20 pandemic, while caused by a different virus in a different species, has strikingly similar drivers to 21 COVID-19, and impacts of both infections have multiplied far beyond the original insult. 22 23 Here we describe the temporal and thematic links that reveal notably similar patterns in these 24 two threats, also discussing factors associated with ASF that have compounded the COVID-19 25 pandemic. Commonalities between these pandemics include concerns surrounding 26 transmission to and from wildlife, highly interconnected global travel networks, and concomitant 1 27 stresses on food supply and disease surveillance capacity. Potential future consequences of 28 these pandemics include exacerbation of food insecurity and severe bottlenecks in surveillance 29 capacity in the face of additional human or animal epidemics. These two pandemics underscore 30 the need to incorporate many diverse and representative experts, as well as global cooperation, 31 to improve disease control and prevention strategies and to overcome continuing threats. This 32 approach is consistent with a One Health Framework. 33 34 African Swine Fever 35 Chinese consumers eat 28% of the global meat production, and pork remains the most 36 preferred meat in China, accounting for 60-75% of meat consumption prior to the ASF outbreak. 37 Chinese meat production has increased five-fold since 1980, with per capita consumption rising 38 faster than production over that period and similar growth projected for the foreseeable future3. 39 China remains the primary pork producing country globally, with half of the world’s pigs, 40 upwards of 700 million head per year, living in China. While Chinese pork production has 41 historically been managed by smaller farming units, over the last decade, modern intensive 42 swine rearing facilities have flourished to meet growing demands4. 43 44 The Chinese pork market had been largely unhindered by serious disease threats during its 45 expansion and intensification. However, production has been decimated by the recent 46 emergence of ASF, a viral infection endemic in African swine and in feral swine (Fig. 1). ASF 47 causes fever, lethargy, gastrointestinal disease, and respiratory illness typically leading to death 48 in domestic swine5. ASF has been associated with serious economic ramifications during 49 outbreaks in susceptible animals due to high mortality caused by the virus, the use of culling as 50 a primary control measure, and trade restrictions with unaffected countries. 51 2 52 The first case of ASF in the current epidemic was recorded in China in August 2018, likely 53 attributed to feeding of contaminated swill and/or movement of feral pigs from Mongolia and 54 Eastern Europe into China6. In order to halt the spread of ASF, the Chinese government 55 mandated strict culling laws, with a recommendation to slaughter every pig within 3km of a 56 known infection7. Despite these orders, ASF has spread to all mainland provinces. Estimates of 57 the number of slaughtered pigs range from 150-200 million, which represents 30% of all 58 Chinese pigs, though the true figure may approach 50-70% of the total pig population8, 9. 59 Although the economic impacts of ASF are still being tallied, some scenarios have calculated a 60 1% reduction in China’s GDP ($100B U.S.)10. It is also estimated that the incursion of ASF into 61 china killed half of breeding sow stocks, this resulting in lower production of pigs (China Ministry 62 of Agriculture). As of August 2020, the virus has additionally spread to many Asian countries 63 including Vietnam, Cambodia, Indonesia, and India, causing significant impacts to pork 64 production across Asia and Europe11, and ASF was recently reported in several feral swine in 65 Eastern Germany12. 66 The rapid spread of ASF has been influenced by a variety of factors, some intrinsically related to 67 the virus, and others to governance, culture, and economy (Fig. 2). ASF is a hardy and stable 68 virus, reported to survive both high temperatures and freezing, and can survive for long periods 69 of time on food products, waste, fomites, and other pigs13. The feeding of kitchen waste 70 (including both raw and cooked pork) is a common cultural practice in China, which results in a 71 rapid chain of transmission between animals. Pig density was identified as the most important 72 predictor of an ASF outbreak; thus, the economic drive trend for consolidation of pork 73 production in intensive rearing conditions has also contributed to the spread of the epidemic14. 74 75 In addition to viral attributes, environmental risks, and cultural practices, there are unique 76 aspects of the Chinese food economies that likely contributed to the spread of ASF. The 77 Chinese pork market is largely non-automated, emphasizing the affinity in China for “warm 3 78 meat” (Fig. 2). Warm meat describes a system of slaughter, process, and transport that relies 79 on a truck-based refrigeration system to deliver pigs to markets within 24 hours15. 80 Consequently, pigs raised in one province may be shipped hundreds of miles to a 81 slaughterhouse and presented at market shortly thereafter, presenting challenges for disease 82 outbreak tracing and containment. Another key element in the food culture of China that may 83 have contributed to ASF spread is the decision to purchase food at a “wet market” versus a 84 supermarket. “Wet markets” refer to those locations offering fresh meat, seafood, and produce, 85 and differ from “wildlife markets”, which specialize in the sale of live wildlife, both farmed and 86 wild-caught16. These terms are often used interchangeably and in some wet markets, wildlife is 87 also sold. Wet markets complicate ASF control as there are reports of live pigs and pig products 88 in close association15. 89 90 The Chinese government was reported to limit some initial communication on the spread of 91 ASF17. In the fall of 2019, Chinese authorities increased positive media around pork production, 92 using a strategy that was described by Chinese political analysts as a reaction to concern for 93 “social stability”18. Although messaging around ASF was overshadowed by news about COVID- 94 19 for several months, the Chinese government increased communications aimed at restoring 95 pork production and expanding pork imports in early 202019.
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