This past year the whole world was pulled into the life of an epidemiologist.
Epidemiologists in the Canadian Food Inspection Agency’s (CFIA) Animal Health Science Directorate are used to following infectious diseases around the world as they come and go. These emerging diseases sometimes raise the alarm for scientists in multiple countries. In some cases, when they make it into the mainstream media, family and friends express concern as well. The work of epidemiologists was at the forefront and words like the “R number” became a common household term, as the rise of the SARS-CoV-2 virus brought about a global pandemic. Despite the challenges the pandemic has placed on health systems, economics, food supply, education and mental health, it has also provided opportunities to advance science.
The need for a new approach
In early 2020, the first reports of pet dogs and cats testing positive for SARS-CoV-2 came to light from various countries. As veterinary science specialists from the CFIA’s Animal Health Risk Analysis and Intelligence section, we recognized the need for rapid analysis of risks at the human-animal-environment interface to inform decision-making. Together, we seized the opportunity to engage with a team of experts from across Canada. Experts in public health, animal health and ecosystem health worked together to pilot a collaborative approach to rapid qualitative risk assessments (RQRA).
The term “One Health” recognizes the interconnections between people, animals, plants and their shared environment. This multisectoral and multidisciplinary collaborative approach addresses shared health threats. One Health has been encouraged and modelled by international health agencies such as the World Health Organization (WHO), World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO). These agencies formed a Tripartite and have provided guidance to support countries in this approach. SARS-CoV-2 provides a perfect illustration of the need for a One Health approach.
Building a virtual community and the One Health approach
New infectious diseases are constantly emerging around the world, and are monitored and evaluated for their relevance to the Canadian people, animals, environment and economy. This is the task of the Community for Emerging and Zoonotic Diseases (CEZD). The CEZD is a virtual network that includes representatives from federal, provincial and municipal governments, academia and the private sector. These representatives have an expertise in public, animal and environmental health.
Andrea leads a core team of CFIA staff who, along with community members, rate intelligence signals from around the globe, for relevance to Canada, on a daily basis. The environmental scanning technology, Knowledge Integration using Web Based Intelligence (KIWI) is provided by the Public Health Agency of Canada (PHAC) as a community partner. The core team also holds monthly community calls, organizes webinars, publishes weekly intelligence reports and conducts polls on important signals. The ongoing development of the community before the emergence of COVID-19 created strong relationships across disciplines. This significant professional experience in the coordination and facilitation skills has been essential to enable the RQRA process.
Intelligence signals that have either very high ratings from the Community or variable ratings across sectors prompt a scoping meeting. Community members meet to determine what further analysis might be useful. This might include the need for risk assessment. Providing rapid, yet robust, assessment of risk during an emerging event with high levels of uncertainty can be a challenge, and has been a significant recent focus of the scientific community. Sharon has participated in international initiatives on this topic, such as with the FAO. She incorporates her experience working in public health and as a CFIA risk assessor. One of our key lessons learned is that the risk assessment approach must be tailored to the specific situation and to the needs of risk managers.
The need for a One Health approach to risk assessment has been an important topic internationally, and we are working closely with our colleagues across the globe. For example, we are sharing methodological tools with those involved in One Health signalling and risk assessment in Europe (including the Netherlands, the One Health European Joint Programme, and the Tripartite Joint Risk Assessment Operational Tool). Sharon is also in regular contact with risk assessors in the USA, United Kingdom and Australia. She has also co-authored a qualitative exposure assessment of humans or animals to SARS-CoV-2 from wild, livestock, companion and aquatic animals with the FAO.
To answer a specific risk question, the RQRA process provides a systematic evaluation of the pathway being explored. For companion animals, the first risk question considered the risk of the spread of SARS-CoV-2 from an infected human to their pet and then to another human (other than the one that infected them).
Sharon Calvin and Andrea Osborn are pictured in a video call, sharing an illustration of a companion animal risk pathway.
Working together and applying the One Health approach
The Canadian expert group then began the ongoing and iterative process of group discussion, expert opinion polls and draft formation. Sharing information is a key concept of One Health. For risk assessment, this doesn’t just involve sharing data (some of which might be confidential), but also sharing basic knowledge and expertise (for example, industry practices, wild animal behaviour and the nature of human-animal contact). In emerging disease situations, it’s crucial that this knowledge sharing occur as rapidly as possible, so that all parties are working with the same information. For this RQRA, the information needed to assess the risk was shared among experts in many disciplines during the discussions, and in various drafts of the risk assessment. In parallel to the risk assessment process, continuous cross-communication was also occurring with a PHAC-led working group responsible for developing guidelines on human-animal contact.
Since the first assessment, several research studies and case reports have arisen on the susceptibility of various animal species to SARS-CoV-2. The expert group went on to conduct RQRAs related to livestock species and farmed mink, which assisted with the development of guidance for producers in Canada. Hopefully, as vaccines roll out this year, Canada will begin to recover from this pandemic. Among the virus’s lasting legacies, both bad and good, will be an improved way of working together on One Health risk assessments for the next emerging disease that comes our way.