Journal of Current Emergency Medicine Reports

 

Coronavirus: The Biological Threat of Our Time

Uchejeso M. Obeta1*ORCID ID, Nkereuwem S. Etukudoh2, Chukwudimma C. Okoli3, Maureen O. Ekpere-Ezeugwu4, Kemzi N. Elechi-Amadi5, Chongs E. Mantu6, Chika J. Ezeama7, Obiora R. Ejinaka8

1Department of Medical Laboratory Management, Federal School of Medical Laboratory Science, Jos-Nigeria.

2Department of Medical Microbiology, Federal School of Medical Laboratory Science, Jos-Nigeria.

3Medical Laboratory Services, Hospital Management Board, HHSS, Abuja.

4Department of Pharmaceutical Microbiology and Biotechnology, University of Nigeria, Nsukka.

5Department of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria

6Department of Special Duties, Federal School of Medical Laboratory Science, Jos-Nigeria.

7Department of Medical Microbiology, Federal School of Medical Laboratory Science, Jos-Nigeria.

8Department of Medical Parasitology, Federal School of Medical Laboratory Science, Jos-Nigeria.

*Corresponding Author: Obeta MU, Department of Medical Laboratory Management, Federal School of Medical Laboratory Science, Jos-Nigeria. E-mail: uchejesoobeta@gmail.com.  

Citation: Obeta MU, Etukudoh NS, Okoli CC, Ezeugwu MO, Elechi-Amadi KN, et al. Coronavirus: The Biological Threat of Our Time. Journal of Current Emergency Medicine Reports. 2021;1(1):1-7.

Copyright: © 2021 Obeta MU, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received On: 21st February,2021     Accepted On: 17th March, 2021    Published On: 6th April, 2021

Abstract

Coronavirus started in 2019 and still affecting people in 2021 to the extent of having different variants. Coronavirus (COVID-19) infectivity, spread, and fatality have raised issues as a biological threat against mankind. This paper takes a brief review of the COVID-19 and associated issues with human diseases and biological threats to lives. SARS-COV, MERS-COV, and COVID-19 are not only zoonotic but have devastating features against humans that need attention. COVID-19 could be one of the biological weapon products and there is an urgent need for international bodies to address scientists and researchers based on bioethics and human rights and as well encourage the healthcare givers for the task of managing and eradicating the pandemic and all form of associated threats.

Keywords: COVID-19, Coronavirus, SARS-COV, MERS-COV, Threat, Bioweapon, Biowarfare.

Introduction

Biological threat and bioterrorism discussion has increased exponentially and saliently in the security discourse of recent especially last decade partly because of anthrax letter attack [1]. This discussion should continue as SARS-COV, MERS-COV, and COVID-19 are continually compared of resent in terms of fatality, severity, zoonosis and possible origin traced to bats [2, 3].

The emergence of COVID-19 in late 2019 and global spread within the shortest time was alarming to the extent that the average of the countries case fatality rates is 2-3% [4]. There is also the wind of the second wave and variants of the COVID-19 pandemic just within 12 months of report [5] seems to have fueled the second wave of the pandemic in Africa [6].  

However, whereas the bat-to-human transmission of SARS-COV was likely mediated by palm civets as intermediate hosts, humans were likely to acquire MERS-COV from dromedary camels. Human-to-human transmission of MERS-COV does occur but is limited mostly to healthcare environments. Moreover, whereas SARS-COV recognizes angiotensin-converting enzyme 2 (ACE2) as a cellular receptor, COVID-19 just like MERS-COV uses dipeptidyl peptidase 4 (DPP4) to enter target cells [7]. Currently, no antiviral therapy has been approved for the prevention or treatment of the COVID-19 pandemic, although many of them are being developed gradually or undergoing clinical test [2], however, the COVID-19 vaccine is now available with some challenges to address ranging from COVID-19 mutation, second strains, cold chain and supply, accessibility and acceptability, clinical efficacies and reactions, corrupt practices surrounding manufacture, allocation, and distribution [8-10].

A novel Coronavirus (COVID-19) called SARS-COV-2 is a new strain of coronavirus that has not been previously identified in humans. Coronaviruses belong to a large family of viruses that are in both animals and humans. These viruses infect people thereby causing various illnesses like the common cold and other more severe diseases [11].

Coronaviruses (COVs) are of the family Corona viridea which comprises of enveloped, positive-sensed, single-stranded RNA viruses’ group. These viruses harboring the largest genome of 26 – 32 kilobase pairs amongst RNA viruses were termed COVs because of their morphology which is crown-like when examined under an electron microscope.

Structurally, Coronaviruses have a non-segmented genome that shares a similar organization. Approximately two-thirds of the genomes contain two large overlapping open reading frames (ORFIa and ORFIb) which are translated into the ppla and pplab replicase polyproteins. The polyproteins are further processed to generate 16 non-structural proteins designated nsp1-16 while the other portion of the genome contains ORFs for the structural protein, including spike(S), envelope (E), member (M), and nucleo (N) protein. Several lineage-specific accessory proteins are also endorsed by different lineages of COVs [12]. The structure possibly makes the virus capable of mutation and easy to spread.

The fact that COVID-19 is traced to Wuhan, raised serious fears as to the possibility of escape from the laboratory because of the possible escape of the possible harmful organisms from the laboratory [11, 13] but WHO [6] confirmed that COVID-19 is not from the laboratory but could be traced to an animal origin in Wuhan.

Coronavirus Historical Perspectives

The novel Coronavirus sometimes referred to as the Middle East Respiratory Syndrome Coronavirus (MERS COV) was first detected in a patient living in Saudi Arabia in September 2012. Since then, there have been some reported sporadic cases as small clusters or large outbreaks in some parts of the world. Though human-to-human transmission, unfortunately, has been documented on many occasions, more research is still underway to find out the source and transmission lines. Although the researches aimed to find putative animal reservoir could be an important aspect of controlling the spread of the coronavirus, there should be a more proactive approach to understand the mite and mode of the transmission from animals to humans or from humans to humans, and the type or level of exposures expected to result in infection. There are several possibilities already existing including direct contact with an infected animal, which could be either the reservoir species or an intermediate host species contacts with the places or materials where an infected animal has recently had contact with or contaminated by an animal in form of discharge or excreta. These have been seen to have implicated other zoonotic infections and can as well be in viruses such as coronavirus. Research and studies on the mode of transmission from animal to humans or human to human could proffer measures to be taken to interrupt the virus transmission. Such investigations shall provide data to assess the risk factors for infection thereby reviewing exposure of known cases and comparing them to the rate of exposure in similar uninfected individuals in the general population [14].

Coronavirus has been traced to 1918, 1930, 1965, 1975, 1997, 2005 and the discovery in 2019 [12] otherwise called COVID-19 after 100 years to have the animal to human linkage in transmission. It is zoonotic as the animal to human has been confirmed.  WHO [6] has confirmed COVID-19 to have come from animals. The human-to-human transmission has been published [15]. Coronavirus cannot be far from the cases of plaque in Corfu during the 18th century [16] that was also termed zoonotic and indirectly biological threat in nature. With available scientific knowledge of COVID-19, it could still be handled with observation and well-organized public health services of healthcare providers to effectively restrain, control, and manage the pandemic.

Coronavirus and Zoonotic Implications

Coronavirus has been implicated as zoonotic agents of bioterrorism though it is not classified as a bioterror virus. Zoonotic diseases have been described as disease or infections which are naturally transmitted between vertebrates (animals) and man. In an obligate zoonotic disease, such as anthrax, transmission occurs only from animal to human whereas in facultative zoonosis infections are mostly transmitted among humans [17,18].

COVID-19 is a zoonotic virus as confirmed by the phylogenetic analyses carried out with available genomic sequencing.  Notably, bats appear to be the reservoirs of COVID-19. However, the intermediate host is yet to be identified [19].

The sources and origin of the coronavirus are currently distorted though, WHO has posited that it originated from animals. Human to human transmission has been severally documented. There is an urgent need to employ various measures controlling the spread of the coronavirus, through improved research to understand the mode of transmission from animals to humans or human to human and the type of exposures that reservoir species or an intermediate host species; contact with or consumption of unprocessed animal product; contact with the environmental materials where an infected animal has recently been; or consumption of a food or beverage which has been contaminated by animal excreta [6]. All these are hereby implicating that the coronavirus is a zoonotic infection. Notably, most zoonotic infections have been used in laboratories to produce bioweapons. This statement agrees with Ryan’s [18] view and there is an urgent need to pay close attention to the COVID-19 pandemic so that it could not be used as a bioterror virus.

Coronavirus in Animals and Humans

Animal coronavirus has been known since the late 1930s. Before the first isolation of HCOO-229E strain B814 from the nasal discharge of patients who had contracted cold. Different COVs had been isolated from various infected animals, including turkey, mouse, cow, pig, cat, and dog. In the recent past, research has shown that seven HCOVs have been identified [12].

All community-acquired HCOVs, causing mild to severe symptoms have been adapted to humans in one way or the other. It could also be the form that humans have been adapted for HCOVs and in other words, both could be the survivors of ancient HCOVs pandemic. HCOVs may cause severe disease in humans and humans who developed severe disease may not have been detected, treated, or quarantined thereby making it possible to spread. This can only happen if HCOVs would multiply and replicate in humans to that large number that is sufficient to allow the accumulation of much adaptive mutation that can affect the host mutation factors. In this sense, the longer the SARS-COV-2 or COVID-19 outbreak persists and the more people become infected, the greater chance that it would adapt to humans. If it is adapted too well, COVID-19 transmission in animals and humans may be very difficult to stop by isolation, quarantine or other infection control adopted measures [5,12].

For many years, the formed community COVs circulate in the human population and trigger common cold among immunocompetent subjects. These viruses do not need to be in an animal reservoir before infection can occur. In contrast, highly pathogenic SARS-COV and MERS-COV have not adapted to humans well and their transmission within humans cannot be sustained. There is a serious need to maintain or propagate that zoonotic reservoirs should not have the chance to spill over to susceptible human targets, possibly by one or more intermediate and amplifying hosts. It is still unclear whether this virus can adapt fully to humans and circulate within humans without a reservoir or intermediate animal host [12].

The Biological Threat of Coronavirus

Bearing in mind that zoonotic viruses and other microorganisms could be used for a biological threat such as bioweapons, there should be a global effort to curtail the use of COVID-19 as a bioweapon. Bioterrorism is a form of terrorism where there is the intentional release of biological materials or agents such as viruses, bacteria, fungi, or germs to cause harm, illness, or death to people, livestock, and crops. It is an unlawful use of microorganisms to inflict various forms of harmful incidence or injuries to the human, whole population, and the environment [19].

Consideration the fact that various research laboratories that have Basic safety laboratories (BSL) such as BSL-3 (P3) or BSL-4 (P4) may have possible leakage of pathogens from such laboratories and can as well be a potential way to develop some biological weapons [13], and subsequently become a threat to humanity. Notwithstanding, U.S. intelligence has warned that the safety risks of such laboratories should still be given attention to avoid the spread of bioparticles in form of diseases or pandemics [20]. This position especially with regards to COVID-19 is necessary considering that many have died because of human-made plaques in form of bioweapons in the past [21].

WHO classified coronavirus as a zoonotic virus. The result of phylogenetic analyses revealed the genomic sequence that bats appear to be the reservoir of COVID-19 [22]. However, the intermediate hosts have not yet been identified. Game animals, dogs, camels, cats, and so on have been suggested host though not confirmed especially with the current COVID-19 pandemic. Many questions are still flying on the biological potentials of COVID-19 [11].

Management and Control of COVID-19 Terror

Monitoring and reporting: COVID-19 should be monitored and any suspected case should be reported.

Strengthening ports of entry and quarantine: Agencies should be strict on the exit and entry protocols to and from various cities.  

Treatment:  All cities and districts transformed relevant hospitals, increased the number of designated hospitals, dispatched medical staff, and set up expert groups for consultation, to minimize mortality of severe patients.  Medical resources from all over are meant to be mobilized to support the medical treatment of patients in the states.

Epidemiological investigation and close contact management: Strong epidemiological investigations should be carried out for contacts, clusters, and cases to identify the source of infection and implement targeted control measures, such as contact tracing and testing.  

Social distancing: All unauthorized gatherings should be avoided to enhance safety based on the measures set by the COVID-19 special task force in various places and countries, Nigeria for example.  Every citizen should be encouraged to wear protecting equipment eg. mask in the company of people.

Funding and material support: Payment of health insurance, salaries, and wages as well as the work to improve accessibility, affordability, and availability of medical materials such as personal protection materials, and ensure basic living materials for infected and affected people.  

The control of COVID-19 biological threat in practical terms should follow all the non-pharmaceutical protocols adopted by WHO and equally follow these measures:

Suspected patients who have not yet been tested should be isolated in single normal pressure rooms; cohorts of positive cases may be accepted depending on the available space and number of affected peoples;

Physicians and all health care workers need to maintain a high level of clinical alert for COVID-19 cases as every patient remains a potential carrier and suspect-

Ensure concurrent testing for other viral pathogens to support a negative COVID-19 test.

Ensure maintenance of usual and essential services during the outbreak of the pandemic.

Ensure that processes are in place for infection prevention among the most vulnerable, including the elderly in various communities.

Ensure readiness to provide clinical care and to meet Infection prevention and control (IPC) needs, including-

  • Anticipated respiratory support requirements (e.g., pulse oximeters, oxygen, and invasive support where appropriate).
  • National guidelines for clinical care should be in regular use for COVID-19.
  • nationally standardized training for disease understanding and personal protection equipment (PPE) use for Health Care Workers (HCWs).
  • Community engagement.  
  • PPE and Medication stockpiles.
  • Early identification protocols; triage, temperature screening, holding bays (triage, including pulse oximetry).
  • Available treatment protocols including designated facilities, patient transportation.
  • Enhanced uptake of influenza and pneumococcal vaccine according to national guidelines.
  • Continuous medical laboratory testing.
  • Rapid response teams inaugurated and readily available.

There exist some international declarations and agreements to ensure that there is serious control of bioweapons. However, the challenge is the lack of mechanisms to ensure compliance, monitoring, and verification of such biological weapon claims at any point in time [23] needs to be addressed. This is a serious matter that needs global attention as a biological threat could raise its ugly head someday.

The United Nations bodies should emphasize sanctions against the scientists who research along the bioterrorism line for an “affirmative moral duty to avoid contributing to the advancement of biowarfare or bioterrorism” [24, 25].

Conclusion

The COVID-19 remains a highly contagious pathogen, can spread quickly, and must be considered capable of causing enormous health, economic and societal impacts in any setting.  COVID-19 is neither SARS nor influenza even though they may have some similar symptoms.  It is important to build scenarios and strategies to exploit all possible measures to slow transmission of the COVID-19, reduce the disease and save lives.

Coronavirus is mostly found in animals and humans and is spreading with astonishing speed. The common signs and symptoms include; dry cough, fever, fatigue, sputum production, sore throat, headache, shortness of breath, myalgia or arthralgia, chills, nasal congestion, nausea or vomiting, diarrhea, hemoptysis, and conjunctival congestion. The COVID-19 incubation period is 1-14 days and all the symptoms should be managed with seriousness to reduce fatality.

The recent pandemic remains the major epidemic around the world. The scientists and researchers should respect human lives and avoid any attempt to expose humans to bioterror or biowarfare preparations and research outcomes having in mind that COVID-19 could be used for biowarfare just like other natural microorganisms like Ebola, SARS, and MERS. Measures towards control and management of the virus must be adhered to by members of society and caregivers to reduce the spread of COVID-19.

This paper agrees with Lyon [26] in his commentary that Biological warfare is of serious concern for military operations both in international and national security frameworks especially with the emergence of bioterrorism materials after the Biological Weapons Convention of 1972 by the United Nations, as there may be no guarantee for future control while agreeing that COVID-19 has characteristics that could lead to biological threat [26-28]. The management and control of COVID-19 should be an eye-opener towards handling a biological threat across the globe.

Acknowledgments

The authors acknowledge Asiya Ibrahim for her technical assistance in the manuscript drafting.

Ethical declarations

There is no ethical consideration in this review work.

Financial Support

None

Conflict of Interests

The authors declare no competing interests.

Authors Contribution

Obeta MU conceptualized the review and all Authors contributed substantially in the manuscript drafting and review, and approved the final version of manuscript.

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