China’s troubles with the on-going coronavirus outbreak originate with its animal health policies and programs: They need to change and here is how.
China is frightened and focused on the 2019 n-CoV virus, now called by the WHO “COVID-19” and by the Chinese “Novel Coronavirus Pneumonia” (NCP). It has paralyzed China’s people, resulting in over 2400 deaths, nearly all in China and over 78,000 infected cases worldwide, fast turning into a pandemic (02/24/2020). This is severely hurting both China’s and the global economy. With respect to human health and the economic and social costs, the numbers are likely to be staggering.
All this began because China, and other countries to be sure, allow live wildlife to be sold as food in so-called “wet” markets, i.e. food markets where wildlife animals are sold in proximity to domestic meat and animals.
For some in China where there is limited food supply, wildlife is a source of protein. For others, it is a traditional and cultural matter of rumored health benefits or simply a delicacy. Whatever the reason, there is a high degree of risks to consumers, both in the permitting country and in our globalized times, well beyond.
But first, how did NCP become the World Health Organization’s latest “Public health Emergency of International Concern.”?
The source of the outbreak is still not definitively known, but it could be bats.
We do know that bats deserve special mention as the probable origin of many infectious disease outbreaks such as SARS and the Nipah virus. Bats are ubiquitous, found almost everywhere. They live in groups with millions of members, they have lifespans of decades and are in close contact with humans. At the same time, humans expand into bat habitats, encroaching into wildlife, displacing the bat population. It is worth noting that bats are also mammals, but the only “flying mammal” in the world.
Virus spillover from bats can happen through their saliva, urine, and on to other species such as civets and pangolins (the latter much appreciated for their keratin). With the Chinese New Lunar Year that lasts a couple of weeks (this year it went from January 25 to February 8), it is not hard to imagine an infected pangolin or civet in a cage housed above live chickens causing contagion during butchering or perhaps eaten insufficiently cooked by future celebrants. When the opportunity presents itself, then the virus spreads quickly, jumping species as a preliminary step to further expansion.
Once it became apparent NCP was deadly and rapidly spreading from the epicenter Wuhan City, the Chinese Government took multiple containment measures, including one less noted: Namely the temporary ban on selling wild animals in the same markets where domestic animals are sold for food.
This “temporary approach”, previously tried with SARS (and never really enforced) could and did lead to increased poaching and a black market. More widely known are China’s massive investments in financial, hospitals and human resources, both at the time of the SARS outbreak in 2002-2003 and now with NCP— all with a heavy emphasis on human health.
This was and is impressive but it falls short of needed investment in animal-to-human prevention policies. Notably, those policies which either permanently ban or provide much better preventive food safety oversight and detection of possible outbreaks in “wet markets”.
Some have argued firmly for a total ban. Dr. Ian Lipkin of Columbia University in an interview with CBS News put it this way:
‘If you take wild animals and you put them into a market with domestic animals or other animals, where there’s an opportunity for a virus to jump species, to adapt from a bat to a small mammal-like a rodent or a ferret, and then jump into humans, you are creating a highway — a superhighway for viruses to go from the wild into people. We can’t do this anymore.”
This position has been supported in some quarters by those with biodiversity concerns. The approach is attractive in theory but not realistic without strong political backing by national authorities. It will be seen as a draconian approach, one likely to meet strong cultural and local political resistance.
There is a practical alternative, however, namely combining better onsite food market regulation with establishing distance separation of domestic and wild animal food stalls.
To work, this measure should be coupled with improved capacity to monitor “wet markets” by food safety personnel, ensuring compliance with health requirements. Also, the social sciences and social media should be involved to help change behavior. With all these measures in place, one can achieve effective preventive action.
But the wildlife food infection risk is but one aspect of broader impact. Even when people are not infected, animal health has affected China’s people and their livelihoods in very significant ways.
As of this writing, the Avian Flu and African Swine Fever have had a devastating effect on the livestock sector, reshaping farming food processing, traditional diets, and pocketbooks of the Chinese and people around the world. The emergence of NCP and SARS illustrates the capacity for coronaviruses to emerge from animal reservoirs and cause disease in humans.
Virologists also know the potential for coronaviruses to cause fatal gastrointestinal or respiratory infections in animals, and for new strains to emerge from unknown reservoirs, and jump species barriers. The emergence of coronaviruses in animals is common.
For example, the porcine epidemic diarrhea (CoV PEDV) first appeared from an unknown source in Asia in the 1980s, causing severe diarrhea and widespread deaths in piglets before becoming endemic in swine. In 2010, this virus reemerged in China and a large-scale outbreak occurred, resulting in significant economic losses. This virus caused also a major outbreak in the United States in 2013. In 2017, events of neonatal piglet diarrhea and death occurred caused by another emerging coronavirus variant known as Swine Acute Diarrhea Syndrome coronavirus (SADS-CoV).
What to do?
Simply put, pursue a One Health approach, one which leads to integrated human-animal-environmental health policies and actions.
To do this China, and other countries to be sure, will need to spend much more on veterinarians, wildlife professionals, food safety officers, and animal virus laboratory professionals.
Most importantly, they need to actively make aware and engage civil society and communities in identifying possible animal diseases, providing incentives for reporting, not fear in so doing. More reference veterinarians and animal health para-professionals, as well as microbiologists and laboratory technicians, and animal and human reference laboratories, are needed to analyze a suspected virus, to prevent and contain, rather than resorting to a costly response.
Building on its NCP outbreak experience, if China took this route it would be a major step in restoring its reputation with its Asian neighbors and demonstrate global community leadership. And of course, it would build back the trust and wellbeing of its own people.
Featured Image: WHO homepage for Nipah Virus (Fruit bats fly above the city center of Abidjan, Côte d’Ivoire) source: N. Bothma
