Dataset Information

Expert elicitation on the relative importance of possible SARS-CoV-2 transmission routes and the effectiveness of mitigations.

ABSTRACT:

Objectives

To help people make decisions about the most effective mitigation measures against SARS-CoV-2 transmission in different scenarios, the likelihoods of transmission by different routes need to be quantified to some degree (however uncertain). These likelihoods need to be communicated in an appropriate way to illustrate the relative importance of different routes in different scenarios, the likely effectiveness of different mitigation measures along those routes, and the level of uncertainty in those estimates. In this study, a pragmatic expert elicitation was undertaken to supply the underlying quantitative values to produce such a communication tool.

Participants

Twenty-seven individual experts from five countries and many scientific disciplines provided estimates.

Outcome measures

Estimates of transmission parameters, assessments of the quality of the evidence, references to relevant literature, rationales for their estimates and sources of uncertainty.

Results and conclusion

The participants' responses showed that there is still considerable disagreement among experts about the relative importance of different transmission pathways and the effectiveness of different mitigation measures due to a lack of empirical evidence. Despite these disagreements, when pooled, the majority views on each parameter formed an internally consistent set of estimates (for example, that transmission was more likely indoors than outdoors, and at closer range), which formed the basis of a visualisation to help individuals and organisations understand the factors that influence transmission and the potential benefits of different mitigation measures.

SUBMITTER: Freeman AL

PROVIDER: S-EPMC8637346 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundThe flaviviruses causing tick-borne encephalitis (TBE) persist at low but consistent levels in tick populations, despite short infectious periods in their mammalian hosts and transmission periods constrained by distinctly seasonal tick life cycles. In addition to systemic and vertical transmission, cofeeding transmission has been proposed as an important route for the persistence of TBE-causing viruses. Because cofeeding transmission requires ticks to feed simultaneously, the timing of tick activity may be critical to pathogen persistence. Existing models of tick-borne diseases do not incorporate all transmission routes and tick seasonality. Our aim is to evaluate the influence of seasonality on the relative importance of different transmission routes by using a comprehensive mathematical model.Methodology/principal findingsWe developed a stage-structured population model that includes tick seasonality and evaluated the relative importance of the transmission routes for pathogens with short infectious periods, in particular Powassan virus (POWV) and the related "deer tick virus," emergent encephalitis-causing flaviviruses in North America. We used the next generation matrix method to calculate the basic reproductive ratio and performed elasticity analyses. We confirmed that cofeeding transmission is critically important for such pathogens to persist in seasonal tick populations over the reasonable range of parameter values. At higher but still plausible rates of vertical transmission, our model suggests that vertical transmission can strongly enhance pathogen prevalence when it operates in combination with cofeeding transmission.Conclusions/significanceOur results demonstrate that the consistent prevalence of POWV observed in tick populations could be maintained by a combination of low vertical, intermediate cofeeding and high systemic transmission rates. When vertical transmission is weak, nymphal ticks support integral parts of the transmission cycle that are critical for maintaining the pathogen. We also extended the model to pathogens that cause chronic infections in hosts and found that cofeeding transmission could contribute to elevating prevalence even in these systems. Therefore, the common assumption that cofeeding transmission is not relevant in models of chronic host infection, such as Lyme disease, could lead to underestimating pathogen prevalence.

Project description:Nearly 4 years after the first report of the emergence of Middle-East respiratory syndrome Coronavirus (MERS-CoV) and nearly 1800 human cases later, the ecology of MERS-CoV, its epidemiology, and more than risk factors of MERS-CoV transmission between camels are poorly understood. Knowledge about the pathways and mechanisms of transmission from animals to humans is limited; as of yet, transmission risks have not been quantified. Moreover the divergent sanitary situations and exposures to animals among populations in the Arabian Peninsula, where human primary cases appear to dominate, vs. other regions in the Middle East and Africa, with no reported human clinical cases and where the virus has been detected only in dromedaries, represents huge scientific and health challenges. Here, we have used expert-opinion elicitation in order to obtain ideas on relative importance of MERS-CoV risk factors and estimates of transmission risks from various types of contact between humans and dromedaries. Fourteen experts with diverse and extensive experience in MERS-CoV relevant fields were enrolled and completed an online questionnaire that examined pathways based on several scenarios, e.g., camels-camels, camels-human, bats/other species to camels/humans, and the role of diverse biological substances (milk, urine, etc.) and potential fomites. Experts believed that dromedary camels play the largest role in MERS-CoV infection of other dromedaries; however, they also indicated a significant influence of the season (i.e. calving or weaning periods) on transmission risk. All experts thought that MERS-CoV-infected dromedaries and asymptomatic humans play the most important role in infection of humans, with bats and other species presenting a possible, but yet undefined, risk. Direct and indirect contact of humans with dromedary camels were identified as the most risky types of contact, when compared to consumption of various camel products, with estimated "most likely" incidence risks of at least 22 and 13% for direct and indirect contact, respectively. The results of our study are consistent with available, yet very limited, published data regarding the potential pathways of transmission of MERS-CoV at the animal-human interface. These results identify key knowledge gaps and highlight the need for more comprehensive, yet focused research to be conducted to better understand transmission between dromedaries and humans.

Project description:The SARS-CoV-2 pandemic has caused immense social and economic costs worldwide. Most experts endorse the view that the virus has a zoonotic origin with the final spillover being associated with wildlife trade. Besides human consumption, wild animals are also extensively traded as pets. Information on zoonotic diseases has been reported to reduce consumer demand for exotic pets. We conducted a global survey and collected 162 responses from international experts on exotic pet trade (traders, academics, NGOs, enforcement entities) to understand how the legal and illegal trade of exotic pets is expected to be affected by the ongoing coronavirus pandemic. Our results suggest that legal purchase of exotic pets is perceived as decreasing during the first pandemic wave due to: lower availability of animals for trade, suppliers' inability to reach consumers and social distancing measures. The general perception is that in the future (i.e., next five years), both demand and supply of legally traded exotic pets are expected to either remain unchanged or decrease only temporarily. The consumer demand for illegal exotic pets is also expected to remain unchanged following the outbreak. The top two challenges reported by respondents, when considering the consequences of the pandemic for the exotic pet trade, are inadequate enforcement of national regulations and increased illegal trade. Our results suggest that the negative consequences of a zoonotic outbreak may not dissuade consumers of exotic pets. Worldwide, the transit/storing conditions and lack of health screenings of traded live animals are conducive to spreading diseases. Consumer demand is a key driver of trade, and enforcement of trade regulations will remain challenging, unless factors driving consumer demand are adequately incorporated in problem-solving frameworks. We emphasize the complexity of trade dynamics and the need to go beyond bans on wildlife trade. Stronger law enforcement, implemented along with initiatives dissuading consumption of wild exotic pets, are essential to sustainably satisfy the market demand.