Broad-spectrum mono- and combinational drug therapies for global viral pandemic preparedness

Broadly effective antiviral therapies must be developed to be ready for clinical trials, which should begin soon after the emergence of new life-threatening viruses. Here, we pave the way towards this goal by analyzing conserved druggable virus-host interactions, mechanisms of action and immunomodulatory properties of broad-spectrum antivirals (BSAs), routes of BSA delivery, and BSA interactions with other antivirals. Based on the analysis we developed scoring systems, which allowed us to predict novel BSAs and BSA-containing drug combinations (BCCs). Thus, we have developed a new strategy to broaden the spectrum of BSA indications and predict novel mono- and combinational therapies that can help better prepare for imminent future viral outbreaks.

Utilization of SARS-CoV-2 Wastewater Surveillance in Africa—A Rapid Review

Wastewater-based epidemiology for SARS-CoV-2 RNA detection in wastewater is desirable for understanding COVID-19 in settings where financial resources and diagnostic facilities for mass individual testing are severely limited. We conducted a rapid review to map research evidence on the utilization of SARS-CoV-2 wastewater surveillance in Africa. We searched PubMed, Google Scholar, and the World Health Organization library databases for relevant reports, reviews, and primary observational studies. Eight studies met the inclusion criteria. Narrative synthesis of the findings from included primary studies revealed the testing methodologies utilized and that detected amount of SARS-CoV-2 viral RNA correlated with the number of new cases in the studied areas. The included reviews revealed the epidemiological significance and environmental risks of SARS-CoV-2 wastewater. Wastewater surveillance data at the community level can be leveraged for the rapid assessment of emerging threats and aid pandemic preparedness. Our rapid review revealed a glaring gap in the primary literature on SARS-CoV-2 wastewater surveillance on the continent, and accelerated and adequate investment into research is urgently needed to address this gap.

Living with COVID-19 and Sustaining a Tourism Recovery—Adopting a Front-Line Collaborative Response between the Tourism Industry and Community Pharmacists

While the COVID-19 pandemic evolves and new variants emerge, destinations and cities look to tourism recovery, cautiously rebooting and re-opening borders. Since the start of the pandemic, dramatic lockdowns have been employed, resulting in dire economic and social consequences to the tourism and hospitality industry and creating the need for a more feasible and sustainable response in the post-pandemic era. Pandemic vigilance and resilience at the societal level have become key in pandemic preparedness. However, due to the complexity of managing COVID-19, no clear cross-disciplinary collaborative framework for tourism recovery has been developed. Cross-sector collaboration to collectively integrate resources, capabilities, and experiences should be prioritised to spearhead tourism recovery plans. With insight on public health, pandemic preparedness, and community access, we hypothesised that cross-industry collaboration between the tourism industry and the pharmacist profession is relevant to the measures adopted for recovery from the COVID-19 pandemic. To examine this hypothesis, this study aimed to explore perceptions from key stakeholders in the tourism and the pharmacist sectors on cross-industry collaboration towards COVID-19 management and the “know-how” in developing, adopting, and advancing such a partnership. This exploratory study adopts and advances the ‘Four Cs’ conceptual framework of communication, cooperation, coordination, and collaboration. In terms of our hypothesis, interview responses with tourism executives and CPs confirm the framework’s suitability and the importance of an interdisciplinary collaborative approach between CPs and the tourism sector to craft a sustainable pathway to recovery from COVID-19 and future pandemic measures as borders re-open and international mobility increases. A tourism recovery strategy from this pandemic can occur more judiciously through a collaborative partnership with an extensive network of pharmacists within communities and popular tourism sites, as CPs have valuable healthcare resources and the ability to track and communicate healthcare alerts to tourism destination recovery efforts.

Use of chatbots during the coronavirus pandemic: A scoping review and case study (Preprint)

BACKGROUND Digital technologies such as chatbots have been widely used during the pandemic. However, the use of such technologies has both benefits and risks. OBJECTIVE An updated review of COVID-19 chatbots is needed to determine how such technologies can be used to provide maximum health benefits, especially during a pandemic METHODS In this study, we reviewed the literature on the use of chatbots during the COVID-19 pandemic, and identifies any issues and gaps in the literature, so the results can inform future scholars on chatbot and emergency response design and evaluation. RESULTS : The results indicate that chatbots have been widely used at both small and national levels across countries. Known uses of chatbots during the pandemic were in population surveillance, case identification, contact tracing, disease management, and general public communication. Although chatbots have offered ease of use and scalability, concerns have been raised, particularly about how chatbots will ensure data privacy and cybersecurity, bias due to limited user representation, and the risks of misinformation. Thus, we highlight both the benefits and risks of chatbots that provide COVID-related information. We found that chatbots offer speed, scalability, accessibility, personalization, and quickness support for self-care while also reducing hospital load and stigma. Despite these benefits, chatbots have some risks and issues to address, including issues pertaining to the actual effectiveness of chatbots, data privacy, cybersecurity, safety risks, and misinformation. There is also a need for a solid infrastructure, guidance, and representative user groups and engagement. Beyond outlining the key benefits and risks of using chatbots during the COVID-19 pandemic, we also highlighted the best practices from the literature and strategies recommended by the World Health Organization (WHO) and other international organizations to address the key issues in the use of chatbots for pandemic preparedness and response. We also determined the different chatbot strategies used by the WHO to address COVID-19 that are critical in guiding future pandemic preparedness and response efforts worldwide. We found specific use cases showing how interfaces across various sectors, as well as support from different funding sources, are critical to reaching and engaging additional chatbot users and ensuring high chatbot quality. CONCLUSIONS Health systems in the future will likely become digital. Additional guidelines and research must be done in the evaluation and use of new technologies, such as chatbots, in emergency preparedness and response. Collaborations across multiple actors are needed to the ensure efficiency and effectiveness of the use of chatbots in the healthcare system.

Genomic diversification of long polynucleotide fragments is a signature of emerging SARS-CoV-2 variants of concern

Highly transmissible or immuno-evasive SARS-CoV-2 variants have intermittently emerged and outcompeted previously circulating strains, resulting in repeated COVID-19 surges, reinfections, and breakthrough infections in vaccinated individuals. With over 5 million SARS-CoV-2 genomes sequenced globally over the last 2 years, there is unprecedented data to decipher how competitive viral evolution results in the emergence of fitter SARS-CoV-2 variants. Much attention has been directed to studying how specific mutations in the Spike protein impact its binding to the ACE2 receptor or viral neutralization by antibodies, but there is limited knowledge of genomic signatures shared primarily by dominant variants. Here we introduce a methodology to quantify the genome-wide distinctiveness of polynucleotide fragments of various lengths (3- to 240-mers) that constitute SARS-CoV-2 lineage genomes. Compared to standard phylogenetic distance metrics and overall mutational load, the quantification of distinctive 9-mer polynucleotides provides a higher resolution of separation between variants of concern (Reference = 89, IQR: 65-108; Alpha = 166, IQR: 150-182; Beta 130, IQR: 113-147; Gamma = 165, IQR: 152-180; Delta = 234, IQR: 216-253; and Omicron = 294, IQR: 287-315). The similar scoring of the Alpha and Gamma variants by our methodology is consistent with these strains emerging at approximately the same time and circulating in distinct geographical regions as dominant strains. Furthermore, evaluation of genomic distinctiveness for 1,363 lineages annotated in GISAID highlights that polynucleotide diversity has increased over time (R2 = 0.37) and that VOCs show high distinctiveness compared to non-VOC contemporary lineages. To facilitate similar real-time assessments on the competitive fitness potential of future variants, we are launching a freely accessible resource for infusing pandemic preparedness with genomic inference ("GENI" — https://academia.nferx.com/GENI). This study demonstrates the value of characterizing new SARS-CoV-2 variants by their genome-wide polynucleotide distinctiveness and emphasizes the need to go beyond a narrow set of mutations at known functionally salient sites.

Patterns of Changes in Oncological Care due to COVID-19: Results of a Survey of Oncological Nurses and Physicians from the Region of Hanover, Germany

Background: Healthcare staff is confronted with intensive decisional conflicts during the pandemic. Due to the specific burden of this moral distress in oncology, the investigation aimed at quantification of these conflicts and identification of risk factors that determine the extent and severity of these conflicts. We examined the heterogeneity of changes in oncology care due to COVID-19. Methods: We conducted a survey of oncological physicians and nurses in the region of Hanover, Germany in the second half of 2020. Overall, N = 200 respondents, 54% nurses, were included in the sample. Indicators of changes in oncology care were used to determine profiles of changes. To characterize these profiles, a diverse set of variables, including decision conflicts, uncertainty, age, gender, work experience, changes in communication with patients, psychological distress, work stress, process organization, and personnel resources, was obtained. Latent class analysis was conducted to determine these latent profiles. Results: We found that three distinct profiles best described the overall changes in oncology care due to COVID-19 in our sample, with each profile being associated with specific characteristics: (1) “Few Changes in Oncology Care” profile with 33% of participants belonging to this profile, (2) “Medium Changes in Oncology Care” profile with 43% of participants, and (3) “Severe Changes in Oncology Care” profile (24%). Participants from these profiles significantly differed regarding their age, work experience, occupational group, the prevalence of decision conflicts, decision uncertainty, quality of communication with patients, and quality of process organization. Conclusions: Distinct profiles of change in oncology care due to COVID-19 can be identified. Most participants reported small to medium changes, while some participants also reported severe changes. Profiles also differed regarding their associated characteristics. As such, specific consequences for better pandemic preparedness can be derived based on the current study. Future studies should investigate the patterns of changes in routine care due to COVID-19.

Isolation and comparative analysis of antibodies that broadly neutralize sarbecoviruses

The devastation caused by SARS-CoV-2 has made clear the importance of pandemic preparedness. To address future zoonotic outbreaks due to related viruses in the sarbecovirus subgenus, we identified a human monoclonal antibody, 10-40, that neutralized or bound all sarbecoviruses tested in vitro and protected against SARS-CoV-2 and SARS-CoV in vivo. Comparative studies with other receptor-binding domain (RBD)-directed antibodies showed 10-40 to have the greatest breadth against sarbecoviruses and thus its promise as an agent for pandemic preparedness. Moreover, structural analyses on 10-40 and similar antibodies not only defined an epitope cluster in the inner face of the RBD that is well conserved among sarbecoviruses, but also uncovered a new antibody class with a common CDRH3 motif. Our analyses also suggested that elicitation of this class of antibodies may not be overly difficult, an observation that bodes well for the development of a pan-sarbecovirus vaccine.