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Statement in support of the scientists, public health professionals, and medical professionals of China combatting COVID-19

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thelancet/ Published online February 18, 2020
Hong Kong, Hong Kong (LP); University of Chicago,
Chigaco, IL, USA (BR); The Ohio State University,
Columbus, OH, USA (LS); and The University of
Melbourne, Melboune, VIC, Australia (KS)
1 Gorbalenya AE, Baker SC, Baric RS, et al.
Severe acute respiratory syndrome-related
coronavirus: the species and its viruses—a
statement of the Coronavirus Study Group.
bioRxiv 2020; published online Feb 11.
DOI:2020.02.07.937862 (preprint).
2 Zhou P, Yang X-L, Wang X-G, et al.
A pneumonia outbreak associated with a new
coronavirus of probable bat origin. Nature
2020; published online Feb 3. DOI:10.1038/
3 Lu R, Zhao X, Li J, et al. Genomic
characterisation and epidemiology of 2019
novel coronavirus: implications for virus
origins and receptor binding. Lancet 2020;
published online Jan 30. https://doi.
4 Zhu N, Zhang D, Wang W, et al. A novel
coronavirus from patients with pneumonia in
China, 2019. NEJM 2020; published online
Jan 24. DOI:10.1056/NEJMoa2001017.
5 Ren L, Wang Y-M, Wu Z-Q, et al. Identification
of a novel coronavirus causing severe
pneumonia in humans: a descriptive study.
Chin Med J 2020; published online Feb 11.
6 Paraskevis D, Kostaki EG, Magiorkinis G,
Panayiotakopoulos G, Tsiodras S. Full-genome
evolutionary analysis of the novel corona virus
(2019-nCoV) rejects the hypothesis of
emergence as a result of a recent recombination
event. Infect Genet Evol 2020; published online
Jan 29. DOI:10.1016/j.meegid.2020.104212.
7 Benvenuto D, Giovanetti M, Ciccozzi A,
Spoto S, Angeletti S, Ciccozzi M. The 2019-new
coronavirus epidemic: evidence for virus
evolution. J Med Virol 2020; published online
Jan 29. DOI:10.1002/jmv.25688.
8 Wan Y, Shang J, Graham R, Baric RS, Li F.
Receptor recognition by novel coronavirus
from Wuhan: an analysis based on decade-
long structural studies of SARS. J Virol 2020;
published online Jan 29. DOI:10.1128/
9 US Center for Disease Control and Prevention.
Coronavirus disease 2019 (COVID-19)
situation summary. Feb 16, 2020.
summary.html (accessed Feb 8, 2020).
10 Andersen KG, Rambaut A, Lipkin WI,
Holmes EC, Garry RF. The proximal origin of
SARS-CoV-2. Feb 16, 2020; http://virological.
(accessed Feb 17, 2020).
11 Bengis R, Leighton F, Fischer J, Artois M,
Morner T, Tate C. The role of wildlife in
emerging and re-emerging zoonoses.
Rev Sci Tech 2004; 23: 497–512.
12 Woolhouse ME, Gowtage-Sequeria S.
Host range and emerging and reemerging
pathogens. Emerg Infect Dis 2005;
11: 1842–47.
13 NASEM. The National Academies of Science
Engineering and Medicine of the USA.
NAS, NAE, and NAM presidents’ letter to the
White House Office of Science and Technology
Policy. Feb 6, 2020. https://www.
(accessed Feb 7, 2020).
Statement in support of
the scientists, public
health professionals,
and medical
professionals of China
combatting COVID-19
We are public health scientists who
have closely followed the emergence
of 2019 novel coronavirus disease
(COVID-19) and are deeply concerned
about its impact on global health and
wellbeing. We have watched as the
scientists, public health professionals,
and medical professionals of China,
in particular, have worked diligently
and effectively to rapidly identify the
pathogen behind this outbreak, put in
place significant measures to reduce
its impact, and share their results
transparently with the global health
community. This effort has been
We sign this statement in solidarity
with all scientists and health
professionals in China who continue
to save lives and protect global health
during the challenge of the COVID-19
outbreak. We are all in this together,
with our Chinese counterparts in the
forefront, against this new viral threat.
The rapid, open, and transparent
sharing of data on this outbreak is
now being threatened by rumours and
misinformation around its origins. We
stand together to strongly condemn
conspiracy theories suggesting that
COVID-19 does not have a natural
origin. Scientists from multiple
countries have published and analysed
genomes of the causative agent,
severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2),1 and they
overwhelmingly conclude that this
coronavirus originated in wildlife,2-10
as have so many other emerging
pathogens.11,12 This is further supported
by a letter from the presidents of the
US National Academies of Science,
Engineering, and Medicine13 and
by the scientific communities they
represent. Conspiracy theories do
nothing but create fear, rumours, and
prejudice that jeopardise our global
collaboration in the fight against this
virus. We support the call from the
Director-General of WHO to promote
scientific evidence and unity over
misinformation and conjecture.14
We want you, the science and health
professionals of China, to know that
we stand with you in your fight against
this virus.
We invite others to join us in
sup porting the scientists, public
health professionals, and medical
professionals of Wuhan and across
China. Stand with our colleagues on
the frontline!
We speak in one voice. To add your support for this
statement, sign our letter online. LM is editor of
ProMED-mail. We declare no competing interests.
Charles Calisher, Dennis Carroll,
Rita Colwell, Ronald B Corley,
Peter Daszak, Christian Drosten,
Luis Enjuanes, Jeremy Farrar,
Hume Field, Josie Golding,
Alexander Gorbalenya, Bart Haagmans,
James M Hughes, William B Karesh,
Gerald T Keusch, Sai Kit Lam,
Juan Lubroth, John S Mackenzie,
Larry Madoff, Jonna Mazet,
Peter Palese, Stanley Perlman,
Leo Poon, Bernard Roizman, Linda Saif,
Kanta Subbarao, Mike Turner
Colorado State University, Fort Collins, CO, USA
(CC); Scowcroft Institute of International Affairs,
Texas A&M, College Station, TX, USA (DC);
University of Maryland, College Park, MD, USA (RC);
NEIDL Institute (RBC), Boston University (GTK),
Boston, MA, USA; EcoHealth Alliance, New York, NY,
USA (PD); Charité – Universitatsmedizin Berlin,
Berlin, Germany (CD); National Center of
Biotechnology, Madrid, Spain (LE); The Wellcome
Trust, London, UK (JF, JG, MT); School of Veterinary
Science, The University of Queensland, Brisbane,
QLD, Australia (HF); Leiden University Medical
Center, Leiden, Netherlands (AG); Erasmus Medical
Center, Rotterdam, Netherlands (BH);
Emory University, Atlanta, GA, USA (JMH); World
Organization for Animal Health (OIE) Working
Group on Wildlife, New York, NY, USA (WBK);
University of Malaya, Kuala Lumpur, Malaysia (SKL);
Food and Agriculture Organization of the United
Nations, Rome, Italy (JL); Curtin University, Perth,
WA, Australia (JSM); Massachusetts Medical School,
Worcester, MA, USA (LM); University of California at
Davis, Davis, CA, USA (JM); Department of
Microbiology, Icahn School of Medicine, Mt Sinai
Hospital, New York, NY, USA (PP); University of
Iowa, Roy J and Lucille A Carver College of Medicine,
Iowa City, IA, USA (SP); The University of
For the SARS-CoV-2 genome
analysis see
Published Online
February 18, 2020
For the Chinese translation
see Online for appendix
To register your support see
2 Published online February 18, 2020
14 WHO. Director-General’s remarks at the media
briefing on 2019 novel coronavirus on
8 February 2020. Feb 8, 2020. https://www.
(accessed Feb 18, 2020).
... The purpose was to inform the reader how China government has thus far performed in the prevention and control of COVID-19 and to highlight non-pharmacology measures that could effectively, timely reduce the spread of the COVID-19 pandemic globally. Thus, this is consistent with the WHO declaration in the early stages of the outbreak that COVID-19 is the Public Health Emergency of International Concern, based on the International Health Regulation (2005), as he said that China has taken extraordinary and powerful measures, and China has provided an example for responding to the epidemic for many aspects, as it is an extraordinary event to constitute a public health risk to the states through the international spread of the disease, and this potentially required coordinated international cooperation and response to jointly control the virus (26,27). Therefore, the international community needs to work together in the prevention and against the COVID-19 pandemic (28). ...
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Background Chinese government conducted unprecedented massive public health prevention interventions at the national level, which have effectively contained the spread of Coronavirus Disease 2019 (COVID-19) infections. Specifically, the outbreak in Wuhan has been effectively controlled. Meanwhile, the Chinese efforts to contain the virus have been widely recognized. Even the World Health Organization has praised the efforts of the Chinese government and advised other countries to learn from China's experience in the fight against COVID-19. However, the measures that have been conducted by China to effectively prevent the spread of COVID 19 in the country have not been rigorously analyzed. Therefore, this study aimed to explore the characteristics of China's control and prevention strategies, and identify the elements that changed the epidemiological curve of rapidly rising new confirmed cases of COVID-19.Methods Public health intervention measures and their effects on the spread of COVID-19 in terms of daily newly confirmed and cumulative cases were collected between January 20, 2020, and March 5. Notices of the Joint Prevention and Control Mechanism for COVID-19 of the State Council on Implementing Measures in Hubei were collected. Information obtained by relevant important documents and announcements was collected from the official website of the Chinese government. Additionally, from other media platforms, news, articles, and reviews were used to explain the intervention measure. Thus, using these data, we performed a retrospective description of the intervention strategies at three stages.ResultsThe Chinese government adopted non-pharmacological interventions measures (NPIs) timely and efficiently. On February 20, the declining epidemic trend in China indicated that the three strictest disease prevention and control strategies issued by the Hubei Government had contributed to a smooth decline in the spread of the epidemic.Conclusions The NPIs taken by China play a decisive role to control the spread of novel coronavirus outbreaks. Further research and action are needed to ensure a sufficiently sensitive surveillance system and strong response mechanism, including the establishment of a highly accessible laboratory network, maintenance of awareness of both primary healthcare providers and the public, and regular training and exercise of local Centers for Disease Control and Prevention and general practitioners in the community-level.
... For instance, the idea that the Covid-19 virus may have originated in a laboratory initially received little credence, largely because it was supported by notorious conservative discourse actors such as Donald Trump, even though "when Avril Haines, President Biden's director of national intelligence, said the same thing, she too was largely ignored" (Wade, 2021). Scientists rushed to "strongly condemn conspiracy theories suggesting that Covid-19 does not have a natural origin" (Calisher, et al., 2020). When recent enquiries showed it to be a plausible explanation (Engber, 2021;Jäger, 2022;Wade, 2021), the damage to the credibility of science through expressions such as "scientists…overwhelmingly conclude" (Calisher et al., 2020, p. e42) and liberal values of the debate was invariably greater than it would have been if the lab leak discourse had been entertained with reservations rather than strongly condemned. ...
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This conceptual article argues that class is a major factor in the social division and polarisation after the Covid-19 pandemic. Current discourse and communication analyses of phenomena such as compliance with measures and vaccine hesitancy seek explanations mainly in opposing ideological stances, ignoring existing structural inequalities and class relations and their effects on people’s decisions. I approach social cohesion in the Covid-19 pandemic through the theories of epidemic psychology, which sees language as fundamental in social conflicts during pandemics, and progressive neoliberalism, which critiques a post-industrial social class whose assumed moral superiority and talking down to working-class people is argued to be an explanation of many current social conflicts. I argue that these theories construct a valuable theoretical framework for explaining and analysing the social division and polarisation that has resulted from the pandemic. Reducing non-compliance with mitigating measures and vaccine hesitancy to an ideological issue implies that it can be countered by combatting misinformation and anti-vaccination thinking and shutting down particular discourses, which grossly simplifies the problem. The impact that class relations and inequality have on political and health issues, coupled with the characteristics of progressive neoliberalism, may partially explain the rise of populist and nativist movements. I conclude that if social cohesion is to be maintained through the ongoing climate emergency, understanding the impacts of progressive neoliberalism and the role of contempt in exclusionary discursive practices is of utmost importance.
... In other words, they mainly focus on the deconstruction of power and manipulation rather than the reconstruction of solidarity. It is important to investigate the discursive construction of solidarity amid global health crises in crisis communication because this can impact international cooperation and global health governance (Calisher et al. 2020;Mian and Khan 2020;Tay 2021). Moreover, it might affect a country's national image and international affairs in the long run . ...
... Andersen of the Scripps Institute, who was the first to publicly call those who said otherwise conspiracy theorists (Andersen et al., 2020), alerted Fauci to a potential lab accident with Fauci's "fingerprints on it." An emergency phone call was arranged with all the top names in the field who later signed the infamous letter declaring the pandemic a zoonosis (Calisher et al., 2020), including Germany's virus chieftain Christian Drosten, who alarmed the German public in weekly podcasts and frequent TV airings. ...
... Andersen of the Scripps Institute, who was the first to publicly call those who said otherwise conspiracy theorists (Andersen et al., 2020), alerted Fauci to a potential lab accident with Fauci's "fingerprints on it." An emergency phone call was arranged with all the top names in the field who later signed the infamous letter declaring the pandemic a zoonosis (Calisher et al., 2020), including Germany's virus chieftain Christian Drosten, who alarmed the German public in weekly podcasts and frequent TV airings. ...
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Let me start this review with my declaration of conflict of interest, intellectually of course: I have done some background research and reading on mercury toxicity (Mutter et al., 2010; Mutter et al., 2005), from thimerosal (ethylmercury, a preservative that used to be in vaccines until about 10 years ago) and amalgams. This is an area, where Robert F. Kennedy has been politically quite active with his Children’s Health Defence foundation. I am therefore favorably inclined to Kennedy’s activities, although I am certainly not an anti-vaxxer. My personal stance here is: some vaccines are useful and safe, some are not, and likely it is best to take them in separate steps, as we did with our children. I have also done primary research on Covid-19 right from the beginning (Walach & Hockertz, 2020a, 2020b) – modeling (Klement & Walach, 2021), conducting surveys (Walach et al., 2022; Walach, Ruof, et al., 2021), looking at data, blogging in Germany – conducting two highly visible and highly controversial studies (Walach, Klement, et al., 2021a; Walach, Weikl, et al., 2021), which have both been retracted within a week, one of them republished (Walach, Klement, et al., 2021b), the other still under a new review. I was critical of the official Covid-19 narrative as soon as I discovered huge discrepancies between original data and reports in the media, as well as analyses of media-prone scientists that were ostensibly wrong; we have succeeded in publishing a critique of one such dangerously wrong analysis (Dehning et al., 2020) about 2 years after the original one was out, following two rejections and long rounds of reviewing (Kuhbandner et al., 2022). So, I have learned a lot of lessons there. I initially thought, we are dealing with a mistake, due to a novel threat and confusion in how to react. The more I saw and experienced myself, the more I lost that stance of innocence and thought that, perhaps there was an initial accident or problem, but surely very soon some people used it to ride their own hobby horses. Collateral utility, as I call it. That is the reason, why I embarked on my own social-science study: interviews with activists in Germany and elsewhere, who wrote articles, blogged, were visible in the public. I have conducted 13 interviews so far, and the tacit and express knowledge from those interviews is of course also feeding my viewpoint.
... İt can cause respiratory tract infection, and can develop in acute respiratory distress syndrome (ARDS) in severe cases. 1 This disease, which has spread around the world in a short period of time, was declared a pandemic by the World Health Organization on March 11, 2020. 2 Asymptomatic, mild viral infection, pneumonia and ARDS are observed in the clinic. Cases that develop Pneumonia are divided into two groups: mild-moderate pneumonia and severe pneumonia. ...
... For more on the latter, see [44]. 15 Calisher et al. [45] wrote: "We stand together to condemn conspiracy theories suggesting that COVID-19 does not have a natural origin"-meaning there is evidence that the virus originated "in wildlife." The statement, however, belies the fact that a virus originated in wildlife (e.g., in bats as the natural reservoir) but was probably adapted subsequently in a laboratory setting in which gain-of-function experimentation modified the wild type virus that eventually became the infectious SARS-CoV-2 virus, consequent to a series of mutations. ...
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Background: Scientists working to determine the origin of SARS-CoV-2 have failed to find fully compelling evidence so as to settle on a single hypothesis to guide ongoing investigation. There remain two principal hypotheses: (H1) a natural "spillover" event involving human infection transmitted from a reservoir host to an intermediate host; (H2) a laboratory accident, consequent to either laboratory-acquired infection or laboratory leak without such acquired infection. Methods: Here H2 is explored, accounting for discussions in the extant literature pertinent to the scientific legitimacy of the hypothesis (in contrast to popular misinformation that this amounts to a "conspiracy theory"). Results: The literature reviewed, syntheses of facts, and corresponding analysis support calls for forensic investigation in Wuhan, China, including unfettered access to the Wuhan Institute of Virology, so as to either confirm or falsify H2. Conclusions: The task of investigation of H2 is scientifically and morally essential as a matter of research integrity, to assure the international community that adequate measures may be taken to prevent any prospect of a pandemic similar to COVID-19 consequent to a laboratory accident, with further attention globally to enhanced biosafety mechanisms and practices involving pathogens having pandemic potential.
... We therefore recruited participants from the general public (i.e., not "conspiracy theorists"), and addressed them as potential "conspiracy theorists" in relation to their own suspicions towards powerholders. Indeed, there are instances of misuses of the label "conspiracy theory" to discredit legitimate questions (e.g., the accidental lab leak theory of the origin of COVID-19, which has been labelled as a conspiracy theory while it does not correspond to the definition of a conspiracy theory, Calisher et al., 2020;Thacker, 2021). ...
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We examined how individuals who may be labelled ‘conspiracy theorists’ respond to discrimination against ‘conspiracy theorists’. In line with the Rejection-Identification Model (Branscombe et al., 1999), we hypothesized that perceived group-based discrimination against conspiracy theorists would strengthen identification with the ‘conspiracy theorist’ ingroup. We propose that this relationship might be mediated by meta-conspiracy beliefs, that is, the belief that the discrimination of conspiracy theorists is itself a conspiracy. Three studies (Ns = 97, 364, 747) among participants who had been labelled as ‘conspiracy theorist’ in the past (Studies 1 and 2) or who had been labelled as such at the beginning of the experiment (Study 3) revealed robust positive relationships between perceived discrimination of conspiracy theorists, meta conspiracy beliefs, and identification. Furthermore, in Studies 2 and 3, identification was strongly associated with positive intergroup differentiation and pride to be a conspiracy theorist. However, there was no evidence that a manipulation of discrimination with bogus public opinion polls affected ‘conspiracy theorist’ identification or meta-conspiracy beliefs. A Bayesian internal meta-analysis of the studies returned moderate (for group identification) to strong (for meta-conspiracy beliefs) support for the null hypothesis. In contrast, in Study 3, a manipulation of discrimination by powerholders enhanced both identification and meta-conspiracy beliefs. This suggests that the source of discrimination moderates the causal relationship between perceived discrimination of conspiracy theorists and group identification.
The first reported case of a novel coronavirus-2019 (COVID-19) was in China. COVID-19 had substantial consequences on all aspects of society globally. In reaction to the mounting number of cases and deaths associated with COVID-19, global measures such as quarantines, lockdowns, and social distancing were implemented in early 2020. While these strategies may have slowed the rapid spread of the virus, they have harmed people psychologically. In a context of huge uncertainty, psychological issues and health sequelae of the COVID-19 crisis, including stress, anxiety, depression, frustration, and suicide, have progressively emerged. These psychological reactions to COVID-19 infection impair good health and well-being for all ages, specified in the third goal of Sustainable Development Goals (SDG). The achievement of SDG should parallel the global response to the COVID-19 pandemic; they should not counteract each other. In this context, short- and long-term negative effects of psychological reactions may exist, thus urgent strategies to mitigate such a burden is paramount. This chapter discusses the psychological aspects during the COVID-19 by exploring the psychological reactions to this global pandemic of the general population and those involved in the healthcare sector. Further, it explores the impact of the psychological burden on society, including the risk and protective factors. Lastly, preventative strategies to lessen this psychological burden for better health and community well-being are detailed.
Due to the second-quarter transition to normalcy, a number of countries like the United States, Canada, and Western Europe have enjoyed some relief from the COVID-19 epidemic since March 2021.
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Since the SARS outbreak 18 years ago, a large number of severe acute respiratory syndrome-related coronaviruses (SARSr-CoV) have been discovered in their natural reservoir host, bats1–4. Previous studies indicated that some of those bat SARSr-CoVs have the potential to infect humans5–7. Here we report the identification and characterization of a novel coronavirus (2019-nCoV) which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started from 12 December 2019, has caused 2,050 laboratory-confirmed infections with 56 fatal cases by 26 January 2020. Full-length genome sequences were obtained from five patients at the early stage of the outbreak. They are almost identical to each other and share 79.5% sequence identify to SARS-CoV. Furthermore, it was found that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. The pairwise protein sequence analysis of seven conserved non-structural proteins show that this virus belongs to the species of SARSr-CoV. The 2019-nCoV virus was then isolated from the bronchoalveolar lavage fluid of a critically ill patient, which can be neutralized by sera from several patients. Importantly, we have confirmed that this novel CoV uses the same cell entry receptor, ACE2, as SARS-CoV.
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Background: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. Methods: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Jin Yin-tan Hospital of Wuhan, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. Results: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8-99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6-87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. Conclusion: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
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There is a worldwide concern about the new coronavirus 2019‐nCoV as a global public health threat. In this article, we provide a preliminary evolutionary and molecular epidemiological analysis of this new virus. A phylogenetic tree has been built using the 15 available whole genome sequences of 2019‐nCoV, 12 whole genome sequences of 2019‐nCoV, and 12 highly similar whole genome sequences available in gene bank (five from the severe acute respiratory syndrome, two from Middle East respiratory syndrome, and five from bat SARS‐like coronavirus). Fast unconstrained Bayesian approximation analysis shows that the nucleocapsid and the spike glycoprotein have some sites under positive pressure, whereas homology modeling revealed some molecular and structural differences between the viruses. The phylogenetic tree showed that 2019‐nCoV significantly clustered with bat SARS‐like coronavirus sequence isolated in 2015, whereas structural analysis revealed mutation in Spike Glycoprotein and nucleocapsid protein. From these results, the new 2019‐nCoV is distinct from SARS virus, probably trasmitted from bats after mutation conferring ability to infect humans. Highlights • An epidemic by a new Coronavirus, the 2019‐nCoV is worrying worldwide. • The epdiemic originated in Wuhan, China causing severe infections in some cases. • The infection probably originated in bats. • A mutation in the viral spike glycoprotein could have favured the cross‐sepcies tramsnimssion from bats to human.
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In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed another clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).
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There are huge numbers of wild animals distributed throughout the world and the diversity of wildlife species is immense. Each landscape and habitat has a kaleidoscope of niches supporting an enormous variety of vertebrate and invertebrate species, and each species or taxon supports an even more impressive array of macro- and micro-parasites. Infectious pathogens that originate in wild animals have become increasingly important throughout the world in recent decades, as they have had substantial impacts on human health, agricultural production, wildlife-based economies and wildlife conservation. The emergence of these pathogens as significant health issues is associated with a range of causal factors, most of them linked to the sharp and exponential rise of global human activity. Among these causal factors are the burgeoning human population, the increased frequency and speed of local and international travel, the increase in human-assisted movement of animals and animal products, changing agricultural practices that favour the transfer of pathogens between wild and domestic animals, and a range of environmental changes that alter the distribution of wild hosts and vectors and thus facilitate the transmission of infectious agents. Two different patterns of transmission of pathogens from wild animals to humans are evident among these emerging zoonotic diseases. In one pattern, actual transmission of the pathogen to humans is a rare event but, once it has occurred, human-to-human transmission maintains the infection for some period of time or permanently. Some examples of pathogens with this pattern of transmission are human immunodeficiency virus/acquired immune deficiency syndrome, influenza A, Ebola virus and severe acute respiratory syndrome. In the second pattern, direct or vector-mediated animal-to-human transmission is the usual source of human infection. Wild animal populations are the principal reservoirs of the pathogen and human-to-human disease transmission is rare. Examples of pathogens with this pattern of transmission include rabies and other lyssaviruses, Nipah virus, West Nile virus, Hantavirus, and the agents of Lyme borreliosis, plague, tularemia, leptospirosis and ehrlichiosis. These zoonotic diseases from wild animal sources all have trends that are rising sharply upwards. In this paper, the authors discuss the causal factors associated with the emergence or re-emergence of these zoonoses, and highlight a selection to provide a composite view of their range, variety and origins. However, most of these diseases are covered in more detail in dedicated papers elsewhere in this Review.
The recent emergence of Wuhan coronavirus (2019-nCoV) puts the world on alert. 2019-nCoV is reminiscent of the SARS-CoV outbreak in 2002 to 2003. Our decade-long structural studies on the receptor recognition by SARS-CoV have identified key interactions between SARS-CoV spike protein and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. One of the goals of SARS-CoV research was to build an atomic-level iterative framework of virus-receptor interactions to facilitate epidemic surveillance, predict species-specific receptor usage, and identify potential animal hosts and animal models of viruses. Based on the sequence of 2019-nCoV spike protein, we apply this predictive framework to provide novel insights into the receptor usage and likely host range of 2019-nCoV. This study provides a robust test of this reiterative framework, providing the basic, translational, and public health research communities with predictive insights that may help study and battle this novel 2019-nCoV.
Background: In late December, 2019, patients presenting with viral pneumonia due to an unidentified microbial agent were reported in Wuhan, China. A novel coronavirus was subsequently identified as the causative pathogen, provisionally named 2019 novel coronavirus (2019-nCoV). As of Jan 26, 2020, more than 2000 cases of 2019-nCoV infection have been confirmed, most of which involved people living in or visiting Wuhan, and human-to-human transmission has been confirmed. Methods: We did next-generation sequencing of samples from bronchoalveolar lavage fluid and cultured isolates from nine inpatients, eight of whom had visited the Huanan seafood market in Wuhan. Complete and partial 2019-nCoV genome sequences were obtained from these individuals. Viral contigs were connected using Sanger sequencing to obtain the full-length genomes, with the terminal regions determined by rapid amplification of cDNA ends. Phylogenetic analysis of these 2019-nCoV genomes and those of other coronaviruses was used to determine the evolutionary history of the virus and help infer its likely origin. Homology modelling was done to explore the likely receptor-binding properties of the virus. Findings: The ten genome sequences of 2019-nCoV obtained from the nine patients were extremely similar, exhibiting more than 99·98% sequence identity. Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%). Phylogenetic analysis revealed that 2019-nCoV fell within the subgenus Sarbecovirus of the genus Betacoronavirus, with a relatively long branch length to its closest relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21, and was genetically distinct from SARS-CoV. Notably, homology modelling revealed that 2019-nCoV had a similar receptor-binding domain structure to that of SARS-CoV, despite amino acid variation at some key residues. Interpretation: 2019-nCoV is sufficiently divergent from SARS-CoV to be considered a new human-infecting betacoronavirus. Although our phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans. Importantly, structural analysis suggests that 2019-nCoV might be able to bind to the angiotensin-converting enzyme 2 receptor in humans. The future evolution, adaptation, and spread of this virus warrant urgent investigation. Funding: National Key Research and Development Program of China, National Major Project for Control and Prevention of Infectious Disease in China, Chinese Academy of Sciences, Shandong First Medical University.
Background: A novel coronavirus (2019-nCoV) associated with human to human transmission and severe human infection has been recently reported from the city of Wuhan in China. Our objectives were to characterize the genetic relationships of the 2019-nCoV and to search for putative recombination within the subgenus of sarbecovirus. Methods: Putative recombination was investigated by RDP4 and Simplot v3.5.1 and discordant phylogenetic clustering in individual genomic fragments was confirmed by phylogenetic analysis using maximum likelihood and Bayesian methods. Results: Our analysis suggests that the 2019-nCoV although closely related to BatCoV RaTG13 sequence throughout the genome (sequence similarity 96.3%), shows discordant clustering with the Bat_SARS-like coronavirus sequences. Specifically, in the 5'-part spanning the first 11,498 nucleotides and the last 3'-part spanning 24,341-30,696 positions, 2019-nCoV and RaTG13 formed a single cluster with Bat_SARS-like coronavirus sequences, whereas in the middle region spanning the 3'-end of ORF1a, the ORF1b and almost half of the spike regions, 2019-nCoV and RaTG13 grouped in a separate distant lineage within the sarbecovirus branch. Conclusions: The levels of genetic similarity between the 2019-nCoV and RaTG13 suggest that the latter does not provide the exact variant that caused the outbreak in humans, but the hypothesis that 2019-nCoV has originated from bats is very likely. We show evidence that the novel coronavirus (2019-nCov) is not-mosaic consisting in almost half of its genome of a distinct lineage within the betacoronavirus. These genomic features and their potential association with virus characteristics and virulence in humans need further attention.