This scanning electron microscope image shows SARS-CoV-2 (round gold objects) emerging from the surface of cells cultured in the lab. SARS-CoV-2, also known as 2019-nCoV, is the virus that causes COVID-19.
Photo: National Institute of Allergy and Infectious Diseases (NIAID).
Pandemics, global health and the power of consumer choices
While large investments are currently being poured into the development of vaccines and treatments to control the damage of the current coronavirus outbreak, these (most needed and welcomed) developments are unlikely to shield us from a future epidemic. We cannot afford not having the same sense of urgency to accelerate the development of modern methods of food production, which include the development of substitutes of animal protein.
Typical intensive pig farm in Spain. Photo: Equalia
Cynthia Schuck, evolutionary biologist, data analyst, epidemiologist, science editor and animal welfare researcher.
May 30 2020
The outbreak of the new coronavirus, SARS-CoV-2, is giving the world a taste of what a respiratory virus pandemic is capable of. If in the age of steam engines the 1918 flu virus spread quickly around the world, it is not surprising that at a time of massive global travel this respiratory virus made its way to all corners of the world in a few weeks. To slow down the infection rate and avoid the collapse of health systems, state of emergency and lock-down measures previously only imagined in science fiction movies were announced in multiple countries. If on the one hand the number of direct victims that this virus will make is still uncertain, on the other there is less doubt about the economic disaster that is already unfolding among the most vulnerable populations.
Is it really inevitable to live under an increasing threat of pandemics and other infectious disease epidemics? Is there anything that can be done not only to mitigate their effects, but to reduce the likelihood of their emergence?
Fortunately, the severity of SARS-CoV-2 is not as high as that of the 2002–03 SARS epidemic, where the overall case fatality rate was around 10%, reaching more than 50% in the elderly population. It is difficult to imagine the consequences that such a high lethality would have if combined with the high transmissibility of this new coronavirus. Additionally, the demographic signature of this outbreak is less damaging to the functioning of society than the 1918 or 2009 flu pandemics, which attacked mostly young adults.
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Many in the scientific community talk about the increasing inevitability of pandemics and major disease outbreaks. But is it really inevitable to live under an increasing threat of pandemics and other infectious disease epidemics? Is there anything that can be done not only to mitigate their effects, but to reduce the likelihood of their emergence? If this is our goal, we must rise to the challenge and discuss openly the structural causes underlying these events.
This scanning electron microscope image shows SARS-CoV-2 (orange)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (green) cultured in the lab. Image captured and colorized at NIAID's Rocky Mountain Laboratories (RML) in Hamilton, Montana. Photo: National Institute of Allergy and Infectious Diseases (NIAID).
Infectious Disease Epidemics
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What is the origin of these outbreaks? In the case of the current pandemic, the most likely place of emergence was a wet market in Wuhan, China, where dead and live animals were sold for consumption. Should this hypothesis be confirmed, it would not be not surprising. Over the last century, pandemics and epidemics with pandemic potential predominantly had their origins in the contamination of humans with pathogens from butchered wild animals, or in wild pathogens “cultured” in immunosuppressed animals living in intensive farming systems. This was the case, for example, of the Ebola outbreaks (which still happen), the 2002–2003 SARS epidemics, the swine flu (H1N1pdm) pandemic of 2009 and the multiple avian flu outbreaks. In the latter cases, poultry and swine made the genetic bridge between the wild virus and the virus that finally spread in the human population.
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In response to the coronavirus pandemic, China announced a ban on wildlife trade and consumption (it had also banned it following the 2002–03 SARS outbreak, but the prohibition was similarly short-lived). Although this would be a most welcomed (but late) measure, both in terms of public health and the well-being of animals traded in these markets (often farmed in confinement then kept alive in these markets under conditions of poor hygiene, hunger, thirst, and abuse), it should not create a false sense of security: the risks of infectious disease outbreaks are not restricted to the trade and consumption of wild animals.
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Domesticated species such as chicken, pigs and cattle act as intermediate or amplifier hosts where pathogens can evolve and spill over into humans. Pigs are particularly fit for that purpose, acting as mixing vessels for the recombination of genetic material for multiple viral strains.
Immunosuppression induced by chronic stress, whereby individuals lose partially the immune response that protects them against infection, is a reality in these intensive
production systems.
Additionally, the cramming of large populations of animals at high stocking densities in barren and closed environments promotes the development of high levels of pathogenicity in multiple ways. First, by facilitating the rapid animal-to-animal movement of multiple viral strains and the mixing and recombination of their genetic material. Additionally, viruses are faced with hosts that are incredibly susceptible to infection, where pathogens can multiply rapidly to high levels.
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Moreover, immunosuppression induced by chronic stress, whereby individuals lose partially the immune response that protects them against infection, is a reality in these systems. Although modern facilities have biosecurity protocols in place, the sheer scale of the outputs of these systems (excrement, live and dead animals, their bodily fluids), the dependence on multiple players in the production chain, the transport of live animals nationally and across borders, and the possibility of contamination of the final products makes those measures insufficient.
Typical broiler chicken intensive farm. Photo: hdy1guy / Shutterstock.
Examples of outbreaks abound, but perhaps the best known is that of highly pathogenic avian influenza A viruses, or bird flu. The lethality of this virus, which has already infected humans, is incredibly high, with over half of infected people dying. In 2017 and 2018, outbreaks in poultry were reported in multiple Asian and African countries and in 2020, multiple outbreaks have been announced in the Philippines, Germany and the United States. Fortunately, sustained human-to-human transmission is still unlikely, but it might be a matter of time.
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Losing the battle to infections: antibiotic resistance
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Before the development of antibiotics, humanity lived in a different world. A small cut, if infected, could be fatal. Surgeries were almost unthinkable. Giving birth was a Russian roulette, as perinatal infections could not be treated. Hospitals were places where little could be done to treat the critically ill. All this changed with the discovery of penicillin in 1928, the first antibiotic. Not only did the treatment of wounds and infections become possible, but also invasive medical procedures, surgeries and chemotherapy. Antibiotics opened the gates to the world as we know today.
According to WHO “the world is heading towards a post-antibiotic era in which common infections could kill
once again.”
So it is not surprising that the emergence of antimicrobial-resistant bacteria is currently deemed as one of the biggest threats to global health. Pathogens that cause serious medical problems, or complications from these conditions — such as tuberculosis, various sexually transmitted diseases, urinary tract infections, pneumonia, and hospital infections — have now become resistant to a wide range of antibiotics. According to WHO “the world is heading towards a post-antibiotic era in which common infections could kill once again”. In this unfolding scenario, about 700 thousand deaths per year already occur due to antibiotic-resistant infections, with an estimated 10 million deaths per year due to antibiotic-resistant infections in 2050 (more than cancer or diabetes) in a business-as-usual scenario.
Foods of animal origin can be vehicles for spreading of multi-drug resistance genes.
Although part of the problem is the overuse of antibiotics by the human population, what is less talked about is the fact that most antibiotics (over 70%) sold in the world are not used in humans, but in animals raised in intensive farming systems. In these systems, antimicrobials are widely used not to treat sick animals (which would be justifiable), but prophylactically, to ensure the survival of billions of animals of frail health under the strenuous conditions of factory farms. Not surprisingly, antimicrobial-resistant bacteria have been isolated in several food-producing animals and derived food products (such as chicken and pork meat) sold in traditional supermarkets in nearly every survey that investigated it. Foods of animal origin can be vehicles for spreading of multi-drug resistance genes.
Information on antimicrobial resistance by WHO. Image: WHO.
Isn’t it time to discuss this inconvenient truth?
As far as pathogens with human-to-human transmissibility are concerned, we humans (their hosts) now live in a “big global village”. So the public health logic of “passive-smoking” applies now at a global scale. The borderless dynamics of zoonotic diseases, food contamination and antimicrobial resistance make us all, in some sense, “passive bushmeat eaters”, “passive wet-market visitors”, “passive factory-farm workers” and “passive industrial-meat consumers”.
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We tend to approach each new epidemic and public health crisis independently, rather than recognizing their common drivers. Domesticated animals have been used as food for millennia, but in today’s modern societies we must be honest and admit that the way we raise animals for food is not only unsustainable and unethical, but also a major threat to the human population.
In fact, this is a revolution in the food sector that has already started, with a diverse range of products on that menu that include meat-like products made from plants or even grown
in vats
While large investments are currently being poured into the development of vaccines and treatments to control the damage of the current coronavirus outbreak, these (most needed and welcomed) developments are unlikely to shield us from a future epidemic. We cannot afford not having the same sense of urgency to accelerate the development of modern methods of food production, which include the development of substitutes of animal protein. In fact, this is a revolution in the food sector that has already started, with a diverse range of products on that menu that include meat-like products made from plants or even grown in vats. Ultimately, however, the demand for alternative protein sources must come from the population, and the market will respond appropriately.
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Just as we exercised our citizenship by adopting the necessary measures to curb the advancement of COVID-19 and protect our communities, we must also exercise it with our wallets at the supermarket, and think how best our purchasing and dietary choices can build a safer future for generations to come.
Cynthia received her D.Phil. in Zoology (Evolutionary Biology/Animal Cognition) from Oxford University. Her D.Phil was followed by two research fellowships (at Oxford and Brazil), as well as by various research projects for institutions in the UK, USA and Brazil. As a scientist Cynthia published a number of articles on subjects ranging from the evolution of advanced cognition and disease epidemiology to the mathematical modeling of animal distributions based on climate. She was an invited speaker in conferences in various countries and has taught data analysis and experimental design in the UK and Brazil for several years. Since 2005 she has been involved on several research projects in global health, metrics and sustainability. Cynthia has also worked as a specialist in scientific capacity building in the biological, agricultural and medical sciences, having taught hundreds of university students and researchers. She has worked as a consulting scientist in global health for different research institutions, as well as a pro-bono researcher for various not-for- profit organizations. She currently investigates farm animal health and welfare.
The opinions expressed in this publication are those of the authors. They do not purport to reflect the opinions or views of Equalia or Equalia’s staff.
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