Lino Vella talks about the ‘One Health’ initiative and the need for all the medical/scientific professionals to join forces to beat the COVID-19 virus
We are living in unprecedented times. Some countries have been hit by the COVID-19 pandemic more than others and it is important that all medical/scientific professionals join forces as health specialists to overcome this dreadful situation.
Veterinarians provide important animal and public health disease surveillance to prevent disease outbreaks, including zoonotic diseases which are common to both humans and animals as they share the same ecosystems. Veterinarians also play an effective part in the research of medicines and vaccines, including that of COVID-19. It is not a coincidence that the chief executive officers of two major COVID vaccine-producing companies are both veterinarians. During the pandemic, veterinary clinics and hospitals have provided, throughout Europe, ventilators, laboratory facilities for testing and even human back up.
In this time and age, the protection of animal and human health falls under a number of different professionals and the ‘One Health’ objective, which was set up some years ago, provides coordinated tools to control and eradicate emerging diseases. A case in point is that information on influenza viruses circulating in animals is crucial for the combination of the human influenza vaccine.
The truth is that globalisation, climate change and changes in animal behaviour give pathogens ways to colonise new territories and mutate. For instance, Ebola disease − that mainly circulates from human to human − is also found as a reservoir in animals or is transmitted from animal to animal. One must stress that 60 per cent of existing infectious human diseases are shared with animals (zoonotic); at least 75 per cent of emerging infectious diseases of humans have an animal origin (including Ebola, HIV and influenza), and out of five human diseases appearing each year, three are of animal origin.
The transmission of the COVID-19 virus is from humans to humans as animals do not seem to play a role in the spread of the virus. The current coronavirus outbreak does clearly present a ‘One Health’ situation, requiring all disciplines to join forces in order to control it.
In the 1970s, Malta had three major animal disease outbreaks, two of which (foot and mouth disease) were tackled by a blitz vaccination programme where all animals, a total of 150,000, had their first vaccination within three weeks of the start of the epidemic. In contrast to COVID spread, the FMD virus was able to spread by the wind for up to three kilometres. Vaccination was a must but such an ambitious programme could only be carried out by the veterinary services with the assistance of a group of nurses from the then St Luke’s Hospital. Already at the time, the ‘One Health’ principle was being applied.
Another major outbreak, of African swine fever, could not be tackled by vaccination since a vaccine did not exist. In agreement with the EU (to safeguard other European States), the whole swine population had to be slaughtered and the island rested from swine population for up to two years, since the African swine fever virus can survive for up to two years in the environment.
A number of outbreaks of viral infections throughout the years have affected our farm animals but because they were of no great significance in their spread and pathogenicity, herd immunity was applied.
Before joining the EU, Malta had to present a number of contingency plans to deal with potential animal disease outbreaks. In dealing with the control of animal diseases, we had three pillars of joint response: 1) the specialists, who independently of political interference, have to carry out the necessary approach to control and eradicate the disease outbreak; 2) the community (stakeholders), who have to follow the specialists’ advise and the accompanying legislation; and 3) the politicians who have to provide the logistics and funding.
The Maltese authorities should now be putting pressure... for the setting up of a roadmap for future immediate controls of any pandemic
Unfortunately, this does not seem to be the case in the control of human disease spread. The response by different European countries was very disappointing − some went for herd immunity, others went for complete lockdown and some had a response by continuous interference by populist governments.
Contingency plans differ from country to country, depending on the lifestyle of the population, but the EU had no common basic principles for the control of the COVID-19 epidemic.
This lack of common basic principles was further proved by the vaccine procurement fiasco and the procurement of EMA (European Medicines Agency) unauthorised vaccines by some countries.
In limiting the spread of livestock infectious disease, it is paramount to apply strict movement controls: no movement from farm to farm and controlled movement to abattoirs. It is simple to apply these strict controls on farms but not at all easy in the case of human populations. But where a proper lockdown in COVID-infected states was applied, one cannot deny the success achieved by a number of countries.
Besides a non-movement order, veterinarians must have a very efficient tracing of the disease spread; if not, then the infection will move ahead of the controls and would be out of hand. The claim that some COVID cases are sporadic queries the efficacy of the contact tracing. The inefficacy of the tracing is definitely confirmed by the continuous spread of COVID-19.
Herd immunity, as the word implies in the veterinary sense, is allowing the spread of a disease with limited controls. It can be applied by allowing the virus to spread and have part of the vulnerable livestock population sacrificed. But when vaccination is available and a blitz programme can be applied, one can reach the goal of disease eradication.
However, when no vaccine is immediately available, then one allows the infective virus not only to spread easily but also gives it time to mutate, which is the story behind the COVID-19 scenario. The approved COVID vaccine might not cover all mutants, hence vaccination is not a panacea and other restrictive controls have to be applied. The non-vaccination of the younger generation and the non-vaxxers will definitely have a negative effect on outcome of the population immunity.
In controlling rabies in companion animals, so as to protect the human population, the EU had applied blood testing and passports that included vaccination. Why is it that the EU is now procrastinating in applying the same principle for COVID vaccination? The only way to kickstart internal tourism is to have a passport that includes vaccination or antibody testing. PCR testing does not fully address the freedom of the person from the disease.
In my humble opinion, the World Health Organisation has failed in confirming immediately the seriousness of COVID-19, while the EU failed in adopting a common basic contingency plan to control the spread of the disease. Different opinions from all quarters have confused the stakeholder; it is no surprise that part of the population is ignoring the guidelines by health authorities to curtail the virus. Coronavirus has been around for many years: we have it in cattle (causing diarrhoea), where a vaccine is available. In humans, we had the pre-warning from nature itself − SARS 1 (2002) and MERS (2012) − both are coronaviruses and both had a high mortality rate.
The world population cannot possibly face again another pandemic. Potential viruses, the Marburg, the H5N1 influenza, the Crimean Congo Haemorrhagic, the MERS and the NIPAH are there and it is the responsibility of the WHO to address the production of prototype vaccines ahead of time for each of the viral families most likely to cause a future pandemic. These prototype vaccines would only need to be tweaked to cover the precise strain.
The Maltese authorities should now be putting pressure on the WHO, the EU and the OIE − World Organisation for Animal Health − for the setting up of a roadmap for future immediate controls of any pandemic.
Lino Vella is consultant, Animal Disease Control and Eradication.