Building Resilience to Future Outbreaks - Infectious Disease Risk Financing Solutions for the Central Asia Regional Economic Cooperation Region

This study is part of ADB’s support to CAREC member countries to strengthen their disaster risk management strategies and public sector budget resilience. The technical assistance targets the development of a regional risk transfer solution, and infectious disease risk is being scoped in this context. Potential future scenarios for COVID-19 and the risk profile of other outbreaks have been modeled and presented to governments. This report advances such work to explore possible regional and national risk financing solutions for infectious disease outbreaks. It reviews global practice and develops recommendations for CAREC member states to progress toward a risk financing structure. 

Enterovirus Sequence Data Obtained from Primate Samples in Central Africa Suggest a High Prevalence of Enteroviruses

Enteroviruses infect humans and animals and can cause disease, and some may be transmitted across species barriers. We tested Central African wildlife and found Enterovirus RNA in primates (17) and rodents (2). Some sequences were very similar, while others were dissimilar to known species, highlighting the underexplored enterovirus diversity in wildlife.

Agent-based Models and Complex Networks in Risk Management

In the last decades, the natural sciences have developed models and methods, such as agent-based models or complex networks, to describe and understand complex systems. These methods have begun to spread to actuarial literature and the insurance industry in the early years of the current century. The non-life insurance section (ASTIN) of the International Actuarial Association (IAA) installed the working party “Agent-Based Models, Networks and Cellular Automata in Risk Management” (ANCRM) to shed light on this phenomenon in the actuarial context. The application of these methods in the insurance industry has been discussed for some years very critically. The task of the ANCRM working party is to give a structured overview of scientific contributions to develop a deeper understanding of and new ideas for application in risk evaluation and risk aggregation on P&C and Health insurance. This article intends to create a starting point for future studies of the evolution of these models and is the final report of the ASTIN ANCRM working party.

Multi-Pathogen Even Catalogs: Technical Note

This Technical Note provides an introduction to pathogen event catalogs, which are empirical and simulation-derived datasets that can be used to estimate the frequency and severity of past and potential future infectious disease events. While event catalogs are widely used in the insurance and actuarial fields and in the study of natural hazards, only recently have the techniques used to create such datasets been applied to the study of infectious disease. The Note provides a brief, non-technical overview, intended to inform readers as to the construction, analytical applications, and practical considerations involved in maintaining and using pathogen event catalogs. The Note is not intended to provide guidance on how to construct pathogen event catalogs or conduct in-depth technical analysis. However, it includes citations that contain resources on this topic for interested readers (acknowledging, however, that the peer-reviewed literature is still relatively sparse).

Sequences of Previously Unknown Rhabdoviruses Detected in Bat Samples from the Republic of the Congo

The family Rhabdoviridae contains diverse viruses, including vector-borne and nonvector-borne viruses, some that are human pathogens, including rabies virus and also nonpathogenic viruses. Bats, which are a known reservoir of viruses with zoonotic potential including coronaviruses, also carry multiple rhabdoviruses such as but not limited to lyssaviruses. We collected samples from 193 insectivorous and frugivorous bats in the Republic of the Congo and tested them for rhabdovirus RNA. Four samples were found positive for viral RNA representing sequences of four different, not previously described rhabdoviruses. Although phylogenetic and taxonomic placement of the novel sequences is uncertain, similarities with previously detected rhabdovirus sequences in bats suggest that these could represent vertebrate viruses. Considering the pathogenic risks some rhabdoviruses pose for humans, these results highlight the need for more research and surveillance regarding rhabdoviruses and bats.

The world needs an intergovernmental panel on pandemic risk

Even as immunization programs race against new viral variants, scientists and policymakers around the world are trying to learn from the COVID-19 pandemic about how to better prevent, or at least contain, future pandemics. Multiple reviews are underway, including a Lancet Covid-19 Commission and a High Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response. Other studies and commissions will follow. These efforts are vital but should be considered initial steps toward a greater goal: a sustained program to build knowledge on pandemic risk, akin to the role of the Intergovernmental Panel on Climate Change (IPCC) in systematically assessing scientific research on climate change.

Evaluation of bat adenoviruses suggests co-evolution and host roosting behaviour as drivers for diversity

Adenoviruses (AdVs) are diverse pathogens of humans and animals, with several dozen bat AdVs already identified. Considering that over 100 human AdVs are known, and the huge diversity of bat species, many bat AdVs likely remain undiscovered. To learn more about AdV prevalence, diversity and evolution, we sampled and tested bats in Cameroon using several PCR assays for viral and host DNA. AdV DNA was detected in 14 % of the 671 sampled animals belonging to 37 different bat species. There was a correlation between species roosting in larger groups and AdV DNA detection. The detected AdV DNA belonged to between 28 and 44 different, mostly previously unknown, mastadenovirus species. The novel isolates are phylogenetically diverse and while some cluster with known viruses, others appear to form divergent new clusters. The phylogenetic tree of novel and previously known bat AdVs does not mirror that of the various host species, but does contain structures consistent with a degree of virus–host co-evolution. Given that closely related isolates were found in different host species, it seems likely that at least some bat AdVs have jumped species barriers, probably in the more recent past; however, the tree is also consistent with such events having taken place throughout bat AdV evolution. AdV diversity was highest in bat species roosting in large groups. The study significantly increased the diversity of AdVs known to be harboured by bats, and suggests that host behaviours, such as roosting size, may be what limits some AdVs to one species rather than an inability of AdVs to infect other related hosts.

Challenges in reported COVID-19 data: best practices and recommendations for future epidemics

The proliferation of composite data sources tracking the COVID-19 pandemic emphasises the need for such databases during large-scale infectious disease events as well as the potential pitfalls due to the challenges of combining disparate data sources. Multiple organisations have attempted to standardise the compilation of disparate data from multiple sources during the COVID-19 pandemic. However, each composite data source can use a different approach to compile data and address data issues with varying results. We discuss some best practices for researchers endeavouring to create such compilations while discussing three key categories of challenges: (1) data dissemination, which includes discrepant estimates and varying data structures due to multiple agencies and reporting sources generating public health statistics on the same event; (2) data elements, such as date formats and location names, lack standardisation, and differing spatial and temporal resolutions often create challenges when combining sources; and (3) epidemiological factors, including missing data, reporting lags, retrospective data corrections and changes to case definitions that cannot easily be addressed by the data compiler but must be kept in mind when reviewing the data. Efforts to reform the global health data ecosystem should bear such challenges in mind. Standards and best practices should be developed and incorporated to yield more robust, transparent and interoperable data. Since no standards exist yet, we have highlighted key challenges in creating a comprehensive spatiotemporal view of outbreaks from multiple, often discrepant, reporting sources and provided guidelines to address them. In general, we caution against an over-reliance on fully automated systems for integrating surveillance data and strongly advise that epidemiological experts remain engaged in the process of data assessment, integration, validation and interpretation to identify, diagnose and resolve data challenges.

Ranking the risk of animal-to-human spillover for newly discovered viruses

Significance The recent emergence and spread of zoonotic viruses, including Ebola virus and severe acute respiratory syndrome coronavirus 2, demonstrate that animal-sourced viruses are a very real threat to global public health. Virus discovery efforts have detected hundreds of new animal viruses with unknown zoonotic risk. We developed an open-source risk assessment to systematically evaluate novel wildlife-origin viruses in terms of their zoonotic spillover and spread potential. Our tool will help scientists and governments assess and communicate risk, informing national disease prioritization, prevention, and control actions. The resulting watchlist of potential pathogens will identify targets for new virus countermeasure initiatives, which can reduce the economic and health impacts of emerging diseases. Abstract The death toll and economic loss resulting from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are stark reminders that we are vulnerable to zoonotic viral threats. Strategies are needed to identify and characterize animal viruses that pose the greatest risk of spillover and spread in humans and inform public health interventions. Using expert opinion and scientific evidence, we identified host, viral, and environmental risk factors contributing to zoonotic virus spillover and spread in humans. We then developed a risk ranking framework and interactive web tool, SpillOver, that estimates a risk score for wildlife-origin viruses, creating a comparative risk assessment of viruses with uncharacterized zoonotic spillover potential alongside those already known to be zoonotic. Using data from testing 509,721 samples from 74,635 animals as part of a virus discovery project and public records of virus detections around the world, we ranked the spillover potential of 887 wildlife viruses. Validating the risk assessment, the top 12 were known zoonotic viruses, including SARS-CoV-2. Several newly detected wildlife viruses ranked higher than known zoonotic viruses. Using a scientifically informed process, we capitalized on the recent wealth of virus discovery data to systematically identify and prioritize targets for investigation. The publicly accessible SpillOver platform can be used by policy makers and health scientists to inform research and public health interventions for prevention and rapid control of disease outbreaks. SpillOver is a living, interactive database that can be refined over time to continue to improve the quality and public availability of information on viral threats to human health.

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security.