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 Table of Contents 
REVIEW ARTICLE
Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 48-55  

COVID-19 pandemic—Environmental perspective of COVID-19 and a primer for all of us


1 Department of Trauma and Emergency, 151 Base Hospital, Guwahati, Assam, India
2 Department of Orthopaedics, 151 Base Hospital, Guwahati, Assam, India

Date of Submission02-Jun-2020
Date of Decision09-Sep-2020
Date of Acceptance06-Oct-2020
Date of Web Publication30-Jan-2021

Correspondence Address:
Dr. S K Rai
Department of Orthopaedics, 151 Base Hospital Guwahati, 781029 - Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_1055_20

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  Abstract 


Coronavirus Disease (COVID-19) spread worldwide has created a global pandemic. To reduce the transmission of the virus, the Indian government had imposed a countrywide lockdown on 24 Mar 2020 by suspending all public transport and industries temporarily resulting in loss of jobs in multiple sectors and looming threats to the nation economy. Lockdown on the opposite hand has removed pollutants from the air and thus improved air quality in many cities across the globe. The near-total shutdown of all economic activities except related to essential commodities like medicine and food was only allowed which resulted in the lowering of carbon emission and improvement in global warming and air pollution. This review article indented to bring important features of how the COVID-19 pandemic affects human civilization and the global environment. However, its epidemiology, symptom, possible prevention, and management will briefly describe. Authors have collected data from, PubMed, Embase, Scopus, WHO, and CDC (USA). Severe Acute Respiratory Syndrome is a result of COVID- 19 infection. This virus is transmitted through close contact by respiratory droplets from one person to another. The majority of symptoms of COVID-19 are very much similar to any viral upper respiratory tract infection ( Common Coryza). Any person with the slightest suspicion or has respiratory symptoms related to COVID-19 infection should wear a facemask, keep safe social distancing, observe cough/sneeze etiquettes. The COVID-19 pandemic has taught us a lesson to introspect the way humans are destroying the environment for their benefit. Whatever be the origin or cause, the occurrence of COVID-19 has made a foreground for us to improve the symbiotic relationship between humans, wildlife, and nature.

Keywords: Coronavirus disease, COVID-19, droplet infection, environment, pollution, wildlife


How to cite this article:
Shaki O, Gupta T P, Rai S K. COVID-19 pandemic—Environmental perspective of COVID-19 and a primer for all of us. J Family Med Prim Care 2021;10:48-55

How to cite this URL:
Shaki O, Gupta T P, Rai S K. COVID-19 pandemic—Environmental perspective of COVID-19 and a primer for all of us. J Family Med Prim Care [serial online] 2021 [cited 2021 Feb 25];10:48-55. Available from: https://www.jfmpc.com/text.asp?2021/10/1/48/307870




  Introduction Top


An outbreak of novel coronavirus has been declared by The WHO on 30 Jan 2020, as a “public health emergency of international concern.” Later on it was designated as pandemic on 11 Mar 2020.[1],[2] SARS-CoV-2 (severe acute respiratory syndrome), also known as 2019-nCoV, which was responsible for COVID-19.[3],[4],[5],[6],[7] The said infection has originated from a seafood and live animal market in Wuhan, China where animal were slaughtered. Initially, only 27 unusual pneumonia cases were reported in mid Dec 2019 and in no time converted into a pandemic.[7],[8],[9],[10],[11] Initially it was thought that it was caused by an innocuous virus, as most patients reported fever or difficulty in breathing, a common symptoms of URTIs.[10],[11] Human civilization apart from COVID-19 has seen many pandemics in recent past, for example, H1N1 in 2009, poliomyelitis in 2014, Ebola infection in 2014 in Africa in, Zika virus infection (2016), and Ebola pandemic in DRC (Congo) in 2019.[12],[13]

Apart from above five pandemics, now COVID-19 has been declared pandemic on 30 Jan 2020 by the WHO. These global spread have been responsible for a large number of deaths, morbidities, and loss of economy.

COVID-19 pandemic has caused greatest human suffering as compared to other contagious diseases globally. Other environmental changes such as depletion in ozone layer, air pollution, soil pollution, and rapid urbanization create tremendous threat to our mother earth and health of human being. Rapidly urbanization and rapid development of industries with toxic gases release in large amount allow green gas production and global warming. COVID-19 outbreak may be because of indirect global environmental neglect and changes. Apart from effects on human life, COVID-19 virus disease has slowdown the economy worldwide. Now is the high time where healthcare personnel, public, local, and central governments need to be hand in hand for prevention and its spread.

In this study, our objective is to focus on basic virology, epidemiology, clinical presentation, current testing protocols, prevention, and the impacts of Novel Corona on environment and society and measures to be taken to minimize community spread and other the risk factors.

Virology of COVID-19 and Electron microscope image

The SARS-CoV-2 virus belongs to coronavirus family, because of presence of crown-like structure outer wall.[3],[14] SARS-CoV-1 virus and MERS-CoV virus are also belong to coronavirus family, responsible for the common cold[3],[9],[14],[15], [Figure 1] and [Figure 2].
Figure 1: Electronic microscope image of COVID-19. Source - https://www.cdc.gov/media/subtopic/images.htm(https://phil.cdc.gov/Details. aspx?pid = 23354). Accessed 11 Sep 2020.

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Figure 2: Electron microscope picture showing the spikes on the outer surface of the COVID-19. (source: Eckert A, Higgins D, Centers for Disease Control and Prevention. ID# 23313; 2020. https://phil.cdc.gov/Details.aspx?pid = 23313. Accessed February 18, 2020. (https://phil.cdc.gov/Details.aspx?pid = 23311)

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This COVID 19 (SARS-CoV-2) is a betacoronavirus similar to MERS-CoV and SARS-CoV-1, and is closely associated with bats.[15],[16],[17] Till now no animal source has been pin pointed for COVID-19, early cases were thought to be originated from seafood and live animal market in China.[17],[18],[19]

This review of article is pertinent to primary physician in the form of prevention and how this epidemic has changed the world and its economy. Since there is no treatment of COVID-19, but we primary physician can prevent this by spreading awareness among society about its spread.

Epidemiology

Initially cases of COVID-19 were reported from Hubei, China, and later on, many cases have been reported from China as well from other countries because of inter-person transmission. In the month of Dec 2019, about more than 94% of COVID-19 cases were reported from Hubei Province only, and in Mar 2020, large number of new cases were reported in Germany, Spain, Italy, and the United States of America.[20],[21],[22]

Till now we know that coronaviruses, primarily spreads through close contact (approx. one meter) by cough droplets.[9],[16],[17],[22],[23] COVID-19 virus also gets transmitted through contaminated surfaces with the hand, mouth, nose, and eyes.[17],[24] Patients are at higher risk of spreading the infection when they are most symptomatic.[21],[23] There is no data to support viral shedding in asymptomatic person, whereas it is highest in critically ill patient.[25],[26],[27] Epidemiologic study and its spread in China indicate COVID-19 is highly contagious with sustained spread. In the USA, initially inter-person transmission was limited but has progressed to community transmission in many parts of the USA rapidly.[24]

From initial exposure, the incubation period for COVID-19 thought to be 14 days. But later, mean incubation period was found to be 5.2 days (95% CI 4.1–7.0) but can vary from 02 to 14 days.[18],[28]

Burden of disease

Till date total number of confirmed cases globally is 27, 417,497, distribution country wise has been shown [Figure 3]. However, infection of COVID-19 has been steadily increasing on daily basis worldwide. For detail, see COVID-19 (https://www.who.int/emergencies/diseases/novel-coronavirus-2019.); last access on 9 Sep 2020.[29]
Figure 3: The comparative study of COVID-19 cases of India with other Countries. (Source: WHO, 2020, Accessed date: 9 Sep 2020).

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The worldwide spread of COVID-19 in many countries has created a global pandemic threat [Figure 4].
Figure 4: Current distribution of COVID-19 in different countries. (Source: WHO, 2020, Accessed date: 9 Sep 2020

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Symptoms

Most of the clinical features of COVID-19 are very much similar to common Coryza fever, cough, breathlessness, and fatigue.[15],[16],[28] Many patients in addition to pulmonary symptoms may present with vague symptoms like myalgias, diarrhea, malaise, headache, nausea vomiting, confusion, chest pain, sore throat, running nose and sneezing, nasal congestion, and nausea. Elderly and immunocompromised persons may not show febrile response. Centers for Disease Control and Prevention (CDC) has place a temperature benchmark of 100.0 F° for early detection of potential COVID-19 patient.[28]

Approach to suspected COVID-19 in outdoor department

A general approach to COVID-19 should focus on identifying and isolating patients at risk for infection, informing hospital infection prevention policy and involving local public health authorities, engaging preventive and social medicine specialist, Microbiologist, respiratory medicine physician and critical care medicine specialist in holistic care. The World Health Organization (WHO) has established case and contact definitions for COVID-19 to standardize global surveillance [Table 1].
Table 1: World Health Organization (WHO) case and contact definitions for global surveillance of COVID-19

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Simultaneous efforts of local health society and Central health departments is required to control this pandemic. Facemask is made mandatory to wear by all personnels to minimize transmission to others. It is recommended by CDC for identifying and assessing suspected COVID-19 has been shown in [Figure 5].[31]
Figure 5: Flowchart to Identify and Assess 2019 Novel Coronavirus from the CDC. (Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/2019-nCoV-identify-assess-flowchart-508.pdf. Accessed 9 Sep 2020.)[30]

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COVID-19 and its effect on health globally

How disease related with human health is well studied over the period of time and not a new subject. This pandemic caused by COVID-19 originated from China in Dec 2019 is responsible for a large global outbreak and put public health at risk. COVID-19 virus is highly contagious and transmitted inter-person through droplets, close contact through sneezing, coughing, respiratory droplets, and aerosols [Figure 6].
Figure 6: Pictorial diagram of transmission of COVID 19 infection. (Picture is self explanatory)

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COVID-19 and economy loss worldwide

Pandemics always cause tremendous damage to the society and economical loss. COVID-19 has severely affected the economy globally which may takes years to make good of its losses. Government of various countries have imposed partial to total lockdown to prevent free personnel movement, thus reducing transmission of the disease in the community. All passenger transport movement has been stopped including railway, flight, buses, and ships. Only essential commodities like health, food, milk, LPG items movement is allowed through goods train and trucks. All commercial, educational, spiritual, sports, recreational activity, entertainment facility like cinema hall, health club hall, seminars are closed. In this lockdown, industries are suffering much more than anyone because of stopped production and non- availability of workers. Transportation company, tourism company, hospitality industries are also facing economical loss. Factory output and production level has gone all time low. Developing country like India which has strong economy is now facing increased unemployment because of loss of jobs. For the treatment and rehabilitation of the COVID-19 patients and their families there will be increase in financial burden on patients as well as on governments.[31]

GDP of each country have been affected by Government imposed lockdown. As estimated by Organization for Economic Cooperation and Development (OECD) there will be loss of 2% points in annual GDP growth in each month. Worldwide tourism companies noted significantly dip in revenue by 50% to 70%.[32] After financial emergency in 2008–2009, World Trade Organization and Organization for Economic Cooperation and Development (OECD) have indicated that COVID-19 pandemic is a responsible for decrease in global economy. Media has reported that human civilization and modern society has not seen such a devastative global heath emergency and economical slowdown after the World War-II.[32]

Global environmental effect of COVID-19

As civilization begins, human have started destroying and manipulating the mother nature for its own interest and to meet the undue demand of constantly increasing population. Rapid urbanization, industrialization, deforestation, increased human activity at every level, loss of green fields, and increased carbon emission with greenhouse effect that has detrimental effect on global environment. These increased human activities further pollute water bodies, air, oceans, mountains, depletion of ground water level, depletion of ozone layer, and global warming. This irresponsible human behavior causes tremendous change in biodiversity and ecosystem.[33] Greenhouse gases like CO2 CH4, N2O are large way causing global warming. To satisfy our desire to achieve more and more, we started destroying the nature in numerous and ruthless ways. But because of COVID-19, outbreak many countries like China, USA, Iran, France, Turkey, Taiwan, Italy, Spain, U.K, Germany, South Korea, Australia, African countries, and India and many more are under lockdown from few weeks to few months. Every effort is being made to restrict transmission of the COVID-19 by constrain of people from one location to other. All passenger transport means are closed which significantly reduces use of fossil fuels and emission of greenhouse gases and toxic suspended particles in the air. Air pollution has significantly reduced because of shut down of industries. Should we give thanks to Novel Corona pandemic, which significantly recovered our ecosystems, of course it cannot be at the cost of human lives. Many news channels across the country as well as many people observed a clear sky and mountain peaks for the first time.

This COVID-19 pandemic on one hand has shown its devastating effect on human lives and on other hand, it brought a very positive and healthy change in the environment globally.

Prevention and control of COVID-19 pandemic

Pandemic because of COVID-19 is of all time high that created global threat, which requires response from each country. WHO and Governments of all affected countries must furnish facts to help the public to face such devastating global health threats. In order to minimize the damage caused by COVID-19, infection control, public health agencies are to play an important role to limit the global spread of this virus. Few WHO recommended global strategies are as follows to prevention and control COVID-19 disease.

Prevention of community spread and restricting mass gathering

The main objective of public health department and administration was to restrict mass gathering and to prevent COVID-19 transmission from person to person. WHO has recommended some precautionary measures like regular hand washing with soap/sanitizer, use of face mask, avoid gathering, avoid hand shake, and observe cough etiquette. Various social activities like cultural, religious, meeting, has been postponed by Govt. of different countries. Information technology, Television, print media, and social networking are constantly creating awareness regarding its spread, prevention, and current status of COVID-19 across the globe. The thumb rule is to prevent mass gathering to prevent Corona.

Plantation and deforestation

On earth surface approximately 30% area has been covered by the Forests according to World Wildlife Fund. The constantly increasing human population and growths results in deforestation. Ruscio et al. in 2015[34] reported average rise of temperature, disappearing glaciers lead to increased in ocean levels and increased rate of unexpected climate change like flood, draught, and extreme weather events which affect our ecosystem and human health too. Olivero et al. in 2017 and Afetl et al. in 2018 both has reported different types of diseases in animals and birds because of deforestation.[16],[35] As of today COVID-19 is bat related virus which took many human lives and turned into a pandemic. Many countries are spending billions of dollars to prevent this pandemic by developing diagnostic tools, vaccines, treatment, and antivirus medicines. By deforestation, we are disturbing wild life habitats and the time has come for the world not to destroy forests, respect wild life, stoppage of deforestation for own benefit and to encourage afforestation in every possible corner of earth.

Effect of World population growth on Environment

Uncontrolled and unrestricted increasing human population across the world is not a good sign for our mother earth. It has adversely affected our environment and has various ill effects on human health. Human activities directly affects environmental change.[36] China has the greatest population and constant increase in human population results into deforestation and make people consume all kinds of animals like frog, bats, insects, snakes, etc., Fan et al.[37] from China, in Dec 2019, has reported that COVID-19 has originated from bats that created a havoc in public health worldwide. Traveling from one to another place, in crowded trains, buses, on the streets and staying in overcrowded rooms, apartments, and slum makes human exceedingly vulnerable to new virus. Population control is therefore very much required of this present scenario and thereafter too.

Global judicial restriction and ban on wildlife trade and consumption

We should not forget one very important fact that this COVID-19 pandemic has started from seafood market, Wuhan, China. After this outbreak, Govt. of China has imposed temporary suspension on sale of wildlife where animals such as bats, wolf, pangolin, worms, fishes, annelids, some poisonous fish like puffer fish, Fugu fish and varieties of insects etc., are kept alive during sale. In China, the unrestricted wildlife slaughtering and sale might enhance the risks of emerging new viruses. WHO and many scientists have urged many countries to stop and put a permanent ban on wildlife slaughtering and sale. If these measures are implemented in future, it would help to protect human lives from future pandemics with another unknown deadly virus.

Keeping public health, national security, economical loss and biosafety in mind, the time has come to consider the global ban on wildlife markets and trades.

Treatment

After review of present published data, no specific treatments can be found or exist nor can be recommended with confidence. Many countries are trying their best to develop vaccines which are under study, including DNA-based, vector-based, and protein-based vaccines.[38] Only supportive and symptomatic management is available till date. Clinical trials of antiviral drugs are under consideration, although none are currently approved by the U.S. FDA [Table 2]. More recently, U.S. FDA just approved a clinical trial at Columbia University for plasma from COVID-19 survivors for critically ill patients.
Table 2: COVID-19 therapies under study

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Many published data of non-randomized clinical trials supports the use of convalescent plasma has been shown good results and reduce the mortality rate in patients with COVID-19 infection with respiratory distress who otherwise did not respond to available medication.[30],[31],[32],[33],[34],[35],[36],[37],[38],[39],[40],[41] In other study by Cheng et al. on 1775 SARS patients found that 80 patients transfused with SARS convalescent plasma had a much low death rate, compared to non-transfused patients (12.5% vs. 17%).[39] FDA issued an EUA for convalescent plasma on August 23, 2020 with certain guidelines.[42]

Patients disposal

Critically ill patients, with severe symptoms, require admission and monitoring. Person with mild symptoms with no comorbidities can be discharge with advice for self-quarantine for 2 weeks at home. It is important to prevent transmission of infection to others. Social distancing plays a pivotal role in minimizing the spread of the virus, like limited essential events and small or large gatherings and everyone should maintain at least 02 m distance from each other.[43],[44],[45]

Take home message:

  1. Prevention is better than cure
  2. use of triple ply face mask and hand sanitizer
  3. maintain proper interpersonal distance about 6 feet
  4. wash hand with soap frequently and don't touch face and mouth frequently
  5. avoid going in crowed palaces
  6. consult primary family physician in case of upper respiratory symptoms, loss of smell/test, skin rashes/or any unexplained symptoms.
  7. follow Gov/ICMR/WHO guidelines



  Conclusion Top


In 21st century as human are advancing day by day, we moved forward by destroying our environment resulting in rising of so many natural disaster across the globe. We are not taking proper care to restore the mother nature while moving forward rather destroying it more rapidly. Last few months of COVID-19 induced lockdown has very positive effects on environment and has successfully recovered to a great extent that will have definite positive impact on global environment. Whatever be the origin or cause, the occurrence of COVID-19 has made a foreground for us to improve the symbiotic relationship between humans, wildlife, and nature. In today time of fast growing world and economy, it is essential to know the origin, control the source of disease, reduce its transmission, and use of available medical resources.

Natural disasters and pandemics will come and go as long as humans live on this earth; let's all unite as responsible human beings to make our mother earth free from ill effect of our own activities and trust mother nature, before it is too late.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov). Published January 30, 2020. Accessed February 18, 2020.  Back to cited text no. 1
    
2.
World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Published March 11, 2020. Accessed March 20, 2020.  Back to cited text no. 2
    
3.
New images of Novel Coronavirus SARS-CoV-2 now available|NIH: National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/news-events/novel-coronavirus-sarscov2-images. Accessed March 18, 2020.  Back to cited text no. 3
    
4.
World Health Organization. WHO Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. Published February 11, 2020. Last updated and Accessed June 4, 2020.  Back to cited text no. 4
    
5.
World Health Organization. Q&A on coronaviruses. https://www.who.int/news-room/q-a-detail/q-a-coronaviruses. Published February 11, 2020. Accessed March 08, 2020.  Back to cited text no. 5
    
6.
Naming the coronavirus disease (COVID-2019) and the virus that causes it. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. Accessed March 12, 2020.  Back to cited text no. 6
    
7.
8.
Taylor DB. A timeline of the coronavirus. The New York Times. https://www.nytimes.com/2020/02/13/world/coronavirus-timeline.html. Published February 13, 2020. Accessed March 18, 2020.  Back to cited text no. 8
    
9.
CHP closely monitors cluster of pneumonia cases on Mainland. https://www.info.gov.hk/gia/general/201912/31/P2019123100667.htm  Back to cited text no. 9
    
10.
Chavez S, Long B, Koyfman A, Liang SY. Coronavirus Disease (COVID-19): A primer for emergency physicians. Am J Emerg Med. 2020 Mar 24:S0735-6757(20)30178-9. doi: 10.1016/j.ajem.2020.03.036. Epub ahead of print. PMID: 32265065; PMCID: PMC7102516.  Back to cited text no. 10
    
11.
Oleribe OO, Salako BL, Ka MM, Akpalu A, McConnochie M, Foster M, Taylor-Robinson SD. Ebola virus disease epidemic in West Africa: lessons learned and issues arising from West African countries. Clin Med (Lond). 2015 Feb;15(1):54-7. doi: 10.7861/clinmedicine.15-1-54. PMID: 25650199; PMCID: PMC4954525.  Back to cited text no. 11
    
12.
Molinari N.-A.M., LeBlanc T.T., Stephens W. The impact of a case of Ebola virus disease on Emergency Department visits in Metropolitan Dallas-Fort Worth, TX, July, 2013–July, 2015: An interrupted time series analysis. PLoS Curr. 2018:10. [Google Scholar]  Back to cited text no. 12
    
13.
Hewlett A.L., Varkey J.B., Smith P.W., Ribner B.S. Ebola virus disease: preparedness and infection control lessons learned from two biocontainment units. Curr Opin Infect Dis. 2015;28(4):343–348. [PMC free article] [PubMed] [Google Scholar]  Back to cited text no. 13
    
14.
Yoo JH. The fight against the 2019-nCoV outbreak: an arduous march has just begun. Journal of Korean Medical Science 2019;35(4).  Back to cited text no. 14
    
15.
Allocati et al., 2016 N. Allocati, A.G. Petrucci, P. Di Giovanni, et al. Bat-man disease transmission: zoonotic pathogens from wildlife reservoirs to human populationsCell Death Dis., 2 (2016), Article 16048 Google Scholar  Back to cited text no. 15
    
16.
Afelt A, Frutos R, Devaux C. Bats, coronaviruses, and deforestation: Toward the emergence of novel infectious diseases?. Frontiers in Microbiology 2018;9:702.  Back to cited text no. 16
    
17.
CDC. HAN Archive - 00426|Health Alert Network (HAN). https://emergency.cdc.gov/han/han00426.asp. Published February 11, 2020. Accessed March 19, 2020.  Back to cited text no. 17
    
18.
CDC. 2019 ovel Coronavirus (2019-nCoV) frequently asked questions and answers. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/faq.html. Published February 11, 2020. Accessed March 18, 2020.  Back to cited text no. 18
    
19.
CDC. 2019 Novel Coronavirus (2019-nCoV) situation summary. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Published February 11, 2020. Accessed March 18, 2020.  Back to cited text no. 19
    
20.
WHO Director-General's remarks at the media briefing on COVID-2019 outbreak on 17 February. 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-covid-2019-outbreak-on-17-february-2020  Back to cited text no. 20
    
21.
World Health Organization. Coronavirus disease 2019 (COVID-19) situation report – 60. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200320-sitrep-60-covid-19.pdf?sfvrsn=8894045a_2. Published March 20, 2020. Accessed March 20, 2020.  Back to cited text no. 21
    
22.
CDC. 2019 Novel Coronavirus (2019-nCoV) cases in the U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html. Published March 20, 2020. Accessed March 20, 2020.  Back to cited text no. 22
    
23.
Coronavirus Disease 2019 Transcript for CDC Media Telebriefing. Centers for Disease Control and Prevention. https://wwwdev.cdc.gov/media/releases/2020/s0215-Diamond-Princess-Repatriation.html. Published February 18, 2020. Accessed March 19, 2020.  Back to cited text no. 23
    
24.
CDC. 2019 Novel Coronavirus (2019-nCoV) transmission. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html. Published February 11, 2020. Accessed March 12, 2020.  Back to cited text no. 24
    
25.
Wax R.S., Christian M.D. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anesth Can Anesth. February 2020 [Google Scholar]  Back to cited text no. 25
    
26.
Zou L., Ruan F., Huang M. SARS-CoV-2 viral load in upper eespiratory specimens of infected patients. N Engl J Med. 2020;0(0) null. [Google Scholar]  Back to cited text no. 26
    
27.
Bai Y., Yao L., Wei T. Presumed asymptomatic carrier transmission of COVID-19. JAMA. February 2020 [Google Scholar]  Back to cited text no. 27
    
28.
CDC. 2019 Novel Coronavirus (2019-nCoV) symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html. Published February 11, 2020. Accessed March 19, 2020.  Back to cited text no. 28
    
29.
WHO website at https://www.who.int/emergencies/diseases/novel-coronavirus-2019. last access on 16 May 2020.  Back to cited text no. 29
    
30.
CDC. 2019 Novel Coronavirus (2019-nCoV) flowchart for healthcare professionals. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/identify-assess-flowchart.html. Published February 11, 2020. Accessed March 19, 2020.  Back to cited text no. 30
    
31.
Coronavirus OE. The World Economy at Risk. OECD Economic Outlook, Interim Report March. 2020.  Back to cited text no. 31
    
32.
OECD annual national accounts; OECD trade in value added database, and OECD calculations; OECD 2020, http://www.oecd.org/coronavirus/en/, Accessed date: Accessed date: 7 Sep 2020).  Back to cited text no. 32
    
33.
Bremer et al., 2019 S. Bremer, P. Schneider, B. Glavovic Climate change and amplified representations of natural hazards in institutional culturesOxford Res. Encycl. Nat. Hazard Sci. (2019) https://doi.org/10.1093/acrefore/9780199389407.013.354 Google Scholar  Back to cited text no. 33
    
34.
Ruscio et al., 2015 B.A. Ruscio, M. Brubaker, J. Glasser, W. Hueston, T.W. Hennessy. One health–a strategy for resilience in a changing arctic Int. J. Circumpolar Health, 74 (2015), Article 27913 CrossRefGoogle Scholar  Back to cited text no. 34
    
35.
Olivero et al., 2017 J. Olivero, J.E. Fa, R. Real, et al. Recent loss of closed forests is associated with Ebola virus disease outbreaks Sci. Rep., 7 (2017), Article 14291 Google Scholar  Back to cited text no. 35
    
36.
Shindell et al., 2017 D. Shindell, N. Borgford- Parnell, M. Brauer, A. Haines, J.C.I. Kuylenstierna, S.A. Leonard, V. Ramanathan, A. Ravishankara, M. Amann, L. Srivastava. A climate policy pathway for near- and long-term benefitsScience, 356 (6337) (2017), pp. 493-494 CrossRefView Record in ScopusGoogle Scholar  Back to cited text no. 36
    
37.
Fan et al., 2019 Y. Fan, K. Zhao, Z.L. Shi, et al. Bat coronaviruses in China Viruses, 11 (2019), p. 210  Back to cited text no. 37
    
38.
World Health Organization. DRAFT landscape of COVID-19 candidate vaccines. World Health Organization. https://www.who.int/blueprint/priority-diseases/key-action/novel-coronavirus-landscape-ncov.pdf?ua=1. Published March 20, 2020. Accessed March 21, 2020.  Back to cited text no. 38
    
39.
Cheng Y., Wong R., Soo Y.O., Wong W.S., Lee C.K., Ng M.H. Use of convalescent plasma therapy in SARS patients in Hong Kong. Eur J Clin Microbiol Infect Dis. 2005;24(1):44–46. [PMC free article] [PubMed] [Google Scholar]  Back to cited text no. 39
    
40.
Soo Y.O., Cheng Y., Wong R., Hui D.S., Lee C.K., Tsang K.K. Retrospective comparison of convalescent plasma with continuing high-dose methylprednisolone treatment in SARS patients. Clin Microbiol Infect. 2004;10:676–678. [PMC free article] [PubMed] [Google Scholar]  Back to cited text no. 40
    
41.
Hung I.F., To K.K., Lee C.K., Lee K.L., Chan K., Yan W.W. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin Infect Dis. 2011;52:447–456. [PubMed] [Google Scholar]  Back to cited text no. 41
    
42.
43.
CDC. 2019 Novel Coronavirus (2019-nCoV) healthcare infection prevention and control FAQs for COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-prevention-control-faq.html. Published February 11, 2020. Accessed March 19, 2020.  Back to cited text no. 43
    
44.
CDC. 2019 Novel Coronavirus (2019-nCoV) infection control. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html. Published February 11, 2020. Accessed March 19, 2020.  Back to cited text no. 44
    
45.
World Health Organization. Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts. https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts. Published February 4, 2020. Accessed February 24, 2020.  Back to cited text no. 45
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

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