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      Sources, diffusion and prediction in COVID-19 pandemic: lessons learned to face next health emergency

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          Abstract

          Scholars and experts argue that future pandemics and/or epidemics are inevitable events, and the problem is not whether they will occur, but when a new health emergency will emerge. In this uncertain scenario, one of the most important questions is an accurate prevention, preparedness and prediction for the next pandemic. The main goal of this study is twofold: first, the clarification of sources and factors that may trigger pandemic threats; second, the examination of prediction models of on-going pandemics, showing pros and cons. Results, based on in-depth systematic review, show the vital role of environmental factors in the spread of Coronavirus Disease 2019 (COVID-19), and many limitations of the epidemiologic models of prediction because of the complex interactions between the new viral agent SARS-CoV-2, environment and society that have generated variants and sub-variants with rapid transmission. The insights here are, whenever possible, to clarify these aspects associated with public health in order to provide lessons learned of health policy that may reduce risks of emergence and diffusion of new pandemics having negative societal impact.

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          Factors determining the diffusion of COVID-19 and suggested strategy to prevent future accelerated viral infectivity similar to COVID

          This study has two goals. The first is to explain the geo-environmental determinants of the accelerated diffusion of COVID-19 in Italy that is generating a high level of deaths. The second is to suggest a strategy to cope with future epidemic threats having accelerated viral infectivity in society. Using data on N = 55 Italian province capitals, and data of infected individuals at as of April 7th, 2020, results reveal that the accelerate and vast diffusion of COVID-19 in North Italy has a high association with air pollution of cities measured with days exceeding the limits set for PM10 (particulate matter 10 μm or less in diameter) or ozone in previous years. In particular, hinterland cities with average higher number of days exceeding the limits set for PM10 (and a low intensity of wind speed) have a very high number of infected people on 7th April 2020 (arithmetic mean about 2200 infected, with average polluted days greater than 80), than coastal cities also having days of exceeding the limits set for PM10 or ozone but with high intensity of wind speed (arithmetic mean about 944.70 infected individuals, with about 60 average polluted days); moreover, cities having more than 100 days of air pollution (exceeding the limits set for PM10), they have a very high average number of infected people (about 3350 infected individuals, 7th April 2020), whereas cities having less than 100 days of air pollution, they have a lower average number of infected individuals (about 1014). The findings here also suggest that to minimize the impact of future epidemics similar to COVID-19, the max number of days per year in which Italian provincial capitals can exceed the limits set for PM10 or for ozone, considering their meteorological conditions, is about 48 days. Moreover, results here reveal that the explanatory variable of air pollution in cities under study seems to be a more important predictor in the initial phase of diffusion (on 17th March 2020, b1 = 1.27, p < 0.001) than interpersonal contacts (b2 = 0.31, p < 0.05). In the second phase of maturity of the transmission dynamics of COVID-19, air pollution reduces intensity (on 7th April 2020 with b′1 = 0.81, p < 0.001) also because of indirect effect of lockdown, whereas coefficient of transmission by interpersonal contacts has stability (b′2 = 0.31, p < 0.01). This result reveals that accelerated transmissions dynamics of COVID-19 is due to mainly to the mechanism of “air pollution-to-human transmission” rather than “human-to-human transmission”. Overall, then, transmission dynamics of viral infectivity, such as COVID-19, is due to systemic causes: general factors that are the same for all regions (e.g., biological characteristics of virus, incubation period, etc.) and specific factors which are different for each region (e.g., complex interaction between air pollution, meteorological conditions and biological characteristics of viral infectivity) and health level of individuals (habits, immune system, age, sex, etc.). Lessons learned for COVID-19 in the case study of Italy suggest that a proactive strategy to cope with future epidemics is to also apply especially an environmental and sustainable policy based on reduction of levels of air pollution mainly in hinterland and polluting cities- having low wind speed, high percentage of moisture and fog days-that seem to have an environment that may damage immune system of people and foster a fast transmission dynamics of viral infectivity in society. Hence, in the presence of polluting industrialization in regions that can trigger the mechanism of air pollution-to-human transmission dynamics of viral infectivity, this study must conclude that a comprehensive strategy to prevent future epidemics similar to COVID-19 has to be also designed in environmental and socioeconomic terms, that is also based on sustainability science and environmental science, and not only in terms of biology, healthcare and health sector.
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            Origins of major human infectious diseases

            The ascent of pathogens This week's Review Article tackles the question of the evolution of human pathogens. Analysis of what we know of the origins of 10 tropical and 15 temperate infectious diseases reveals that animals were the source of the majority of important human diseases in the recent past, and that direct contact with animals through activities such as hunting remains a major route for disease acquisition. Modern developments such as industrial food production, vaccine production and blood transfusion may be making us more vulnerable than ever to new pathogens. The authors argue that people with high exposure to wild animals, such as hunters, zoo workers and wildlife veterinarians, should be regularly screened for emergent pathogens.This would provide early warning of newly introduced disease, and supply a repository of tissue samples that would assist in reconstructing the origin of later outbreaks. Supplementary information The online version of this article (doi:10.1038/nature05775) contains supplementary material, which is available to authorized users.
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              Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic

              Attack rate in Manaus Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incidence peaked in Manaus, Brazil, in May 2020 with a devastating toll on the city's inhabitants, leaving its health services shattered and cemeteries overwhelmed. Buss et al. collected data from blood donors from Manaus and São Paulo, noted when transmission began to fall, and estimated the final attack rates in October 2020 (see the Perspective by Sridhar and Gurdasani). Heterogeneities in immune protection, population structure, poverty, modes of public transport, and uneven adoption of nonpharmaceutical interventions mean that despite a high attack rate, herd immunity may not have been achieved. This unfortunate city has become a sentinel for how natural population immunity could influence future transmission. Events in Manaus reveal what tragedy and harm to society can unfold if this virus is left to run its course. Science, this issue p. 288; see also p. 230
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                Author and article information

                Journal
                AIMS Public Health
                AIMS Public Health
                PublicHealth
                AIMS Public Health
                AIMS Press
                2327-8994
                2 March 2023
                2023
                : 10
                : 1
                : 145-168
                Affiliations
                [1] National Research Council of Italy, Department of Social Sciences, Turin Research Area of the National Research Council-Strada delle Cacce, 73-10135 - Torino (Italy)
                Author notes
                * Correspondence: Email: mario.coccia@ 123456cnr.it .
                Article
                publichealth-10-01-012
                10.3934/publichealth.2023012
                10091135
                37063362
                1e408cd7-9ce7-4f5a-bc0a-dd7ecbdd61e2
                © 2023 the Author(s), licensee AIMS Press

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0)

                History
                : 14 November 2022
                : 9 February 2023
                : 19 February 2023
                Categories
                Review

                covid-19 pandemic,infectious diseases,environmental factors,compartmental models,epidemiologic models,outlook,preparedness,surveillance,public health,health policy,policy responses,crisis management

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