B Acad Nat Med Paris
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As of today, September 2021, it is very difficult to predict how the SARS-CoV-2 pandemic will develop in France and around the world. The objective of this review is to analyze recent studies concerning SARS-CoV-2, especially those looking for its origin, particularly in viruses from various bat populations. The ability of variants to escape vaccine responses is a real concern, as these variants show increased pathogenicity. Screening of infected subjects and large-scale sequencing are essential tools to be strengthened, for monitoring the risk of emergence of possible new variants and for the development of the second generation vaccines.
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The health crisis linked to COVID-19 has put the whole hospital under stress. Intensive care units (ICU) have been on the front line to manage the most serious cases. The number of new admissions together with cumulative number of occupied intensive care beds have been and still are a key element in measuring the intensity of the crisis. ⋯ Among the several limiting factors, human resources with qualified personnel was a key element together with the relative shortage of drugs. The mismatch between demand and supply has led to the establishment of rules for prioritizing access to ICU. This review deals with all these issues and can contribute to a reflection on the adaptation of the critical care department to cope with major sanitary crisis.
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B Acad Nat Med Paris · Jan 2022
Review[The different phases of molecular and antigenic evolution of SARS-CoV-2 viruses during the 20 months following its emergence].
From its emergence in December 2019 and until the end of the fourth pandemic wave in October 2021, SARS-CoV-2 circulation has been associated with significant molecular evolutions of the virus. These were linked to mutations that have led to new virus linages with replication advantages as a result of increased transmission, or partial immune escape in the context of progressively increasing global immunisation. The pandemic context with large scale epidemics massive outbreaks observed in highly populated areas has favoured this emergence of "variants". ⋯ For the first time, an unprecedented worldwide surveillance effort has been conducted to monitor the circulation of the emerging virus, with rapid data sharing. This molecular surveillance system has provided an accurate description of the circulating viruses, and their evolution. The implementation of these tools and skills able to provide SARS-CoV-2 molecular epidemiological data has upgraded the global capacity for surveillance worldwide, and may allow us to be better prepared for a future pandemic episode.
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The concept of "one health" applies perfectly to human health and animal health because many diseases are zoonoses. There are many historical examples of effective collaboration between veterinary medicine and human medicine in the development of the first vaccines used in the world (smallpox, rabies, tetanus, diphtheria, tuberculosis, etc.). ⋯ But the most serious crisis that we have known since early 2020 is Covid-19 pandemic, which confirms that the modification of the ecosystems of certain wild species such as the horseshoe bats can have significant consequences for the public health. Animals infected with Covid-19 have been contaminated by humans but we cannot currently exclude an animal reservoir risk for SARS-CoV-2 which has circulated around the world.