Posted on 20/21 March 2020
Status of COVID-19
As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious disease (HCID) in the UK.
The 4 nations public health HCID group made an interim recommendation in January 2020 to classify COVID-19 as an HCID. This was based on consideration of the UK HCID criteria about the virus and the disease with information available during the early stages of the outbreak. Now that more is known about COVID-19, the public health bodies in the UK have reviewed the most up to date information about COVID-19 against the UK HCID criteria. They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.
The Advisory Committee on Dangerous Pathogens (ACDP) is also of the opinion that COVID-19 should no longer be classified as an HCID.
The decision by the ACDP was actually made in their meeting on the 13th March 2020.
ADVISORY COMMITTEE ON DANGEROUS PATHOGENS
COVID -19 meeting held on Friday 13th March, 11:00 – 12:00am.
Thomas Evans (Chair)
Wonnet Hall (DfT)
Munmohan Malli (DfT)
Helen North (DfT)
Keith White (DfT)
Observers/Assessors were present from the Health and Safety Executive (HSE).
Apologies received from Members: Neil Ferguson, Dilys Morgan, Gee Yen Shin.
1.0 Chairman’s opening remarks, welcomes and apologies
The Chair welcomed all attendees to this urgent meeting convened to discuss the transport of suspected COVID-19 samples.
The Chair welcomed and thanked attendees from the Department for Transport (DfT) who have joined this meeting to provide expert advice on the matter.
2.0 Discussion on: “can clinical samples suspect of containing SARS-CoV-2 be transported by an alternative to courier in Category B transport”
The Chair introduced a recurring issue that has arisen due to the transport of clinical samples that potentially contain SARS-CoV-2 agent at Category B.
Clinical laboratories are currently facing difficulties with training and handling of Category B agents including the procurement of materials needed to transport them. An overall shortage of transport materials such as boxes and canisters has been felt across the UK, proving itself as a difficult operational reality of this incident. Thus, the Committee felt that any change to streamline the process and alleviate logistical and operational difficulties the diagnostic laboratories are facing would be extremely beneficial.
Drawing from this discussion the lack of outer packaging used to transport Category B agents was recognised as the most significant issue. However, it was noted by DfT colleagues that the outer packaging often used in NHS trusts is not the only packaging that can be utilised to transport Category B substances despite popular belief. The product for packaging currently widely recognised and used is the result of a manufacturer that has created easy to use pre-printed boxes and subsequently ‘cornered the market’.
UN3373 is the UN number in which Category 3 dangerous goods belong to if they contain diagnostic substances. If a diagnostic substance has been classified as belonging to UN3373, then it must be packed for transport according to P650 guidelines/packing instructions 650. These guidelines outline the list of requirements for the quality and construction of this packaging, agreed with the DfT. If packaging follows this guidance and is marked appropriately any outer packaging obtained from various manufacturers can be used to transport suspect SARS-CoV-2 samples providing several alternatives to the packaging currently used and subsequently in short supply.
The importance of relaying this information back to the relevant parties across the devolved administrations was stressed by the Chair. The Committee concurred and felt that it was essential that some form of communication on P650 requirements is cascaded to Trusts and clinical laboratories that they can then interpret at the local level.
The Chair also put forward a question to the committee regarding the safety of transport of suspect SARS-CoV-2 samples though pneumatic air tube systems in a hospital co-located with a diagnostic laboratory. As these samples are not carried on the road, regulations for carriage of dangerous goods do not apply. However, the Committee agreed that this method of transport is not safe and therefore not recommended.
Finally, DfT attendees noted they have postal capacity for communicable disease sampling that has the potential to be mirrored during this incident.
ACTION: Helen North (DfT) to provide the ACDP chair with the P650 packaging guidelines for the Chair to cascade to the appropriate parties.
ACTION: Chair to advise policy makers that samples suspect of containing SARS-CoV-2 can be transported under less stringent conditions.
3.0 Any other business
The Committee noted that they continued to receive queries regarding point-of-care (POC) testing. These queries have increased as many NHS Trusts are planning to reintroduce molecular testing. The Committee reiterated their advice that POC testing should not be carried out unless a local risk assessment has been conducted. The wording of this advice may need to be altered for clarification purposes.
Secondly, the Chair informed the Committee that he had been contacted by DHSC regarding the classification of COVID-19 as a High Consequence Infectious Disease (HCID). The Committee unanimously agreed that this infection should not be classified as a HCID.
ACTION: Member Rob Shorten to formulate risk assessment advice for point-of-care machines that should/should not be used.
ACTION: The ACDP Chair to formally write to DHSC to inform of the ACDP’s position to declassify COVID-19 as a HCID.
The Chair thanked everyone for attending this teleconference on short notice including colleagues from DfT who provided expert advice on the matter. The Chair also recognised everyone’s ongoing hard work during this incident.
One outstanding issue from these minutes is who from the DHSC were observing the meeting. Certainly one would have been Deputy Chief Medical Officer Jonathan Van-Tam.
Advisory Committee on Dangerous Pathogens
To : Department of Health and Social Care
ACDP Secretariat, Public Health England, 61 Colindale Avenue, London NW9 5EQ
13 March 2020
Classification of COVID-19 as a HCID
I am writing as Chair of the Advisory Committee on Dangerous Pathogens (ACDP). The committee discussed today the classification of COVID-19 as a high consequence infectious disease. The unanimous view of the committee was that this infection should NOT be classified as a HCID.
Professor Tom Evans
Jonathan Van-Tam was involved in another meeting at the same time, that of NERVTAG.
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Minutes of the NERVTAG
COVID-19 Ninth Meeting:
13 March 2020
Date & Location:
11:00 – 12:30, 13 March 2020
Via telecon only
Peter Horby (Chair), Camille Tsang (Secretariat), Emma Petty (Temporary Secretariat)
NERVTAG Members: Peter Openshaw (PO), Ben Killingley (BK) Calum Semple (CSm), Wei Shen Lim (WSL), Robert Dingwall (RD), John Edmunds (JE), Jim McMenamin (JMM), Wendy Barclay (WB)
PHE Observers: Gavin Dabrera (GD), Maria Zambon (MZ),
DHSC Observers: Jonathan Van-Tam (JVT), Ursula Wells (UW), Sadia Dorsani (SD), Bethan Loveless (BL)
SAGE: Catherine Yule (CY)
NHSE: Chloe Sellwood (CSw)
APHA: Ian Brown (IB)
HPS: Lisa Ritchie (LR)
DFID: Cathy Roth(CR)
Neil Ferguson, Andrew Hayward, Cariad Evans, James Rubin Cheryl Cavanagh, Mary Ramsay, Martyn Underdown, David Connell, Kevin Rooney,
1 Introductions …………………………………………………………………………………. 3
2 Adaption of the pandemic flu IPC guidance into COVID-19 version ………. 3
3 The potential for reinfection with SARS-CoV-2 …………………………………… 5
4 AOB and Next Meeting …………………………………………………………………… 8
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NERVTAG COVID-19 EIGHTH MEETING: SUMMARY
NERVTAG RECOMMENDED THE FOLLOWING:
ADAPTION OF THE PANDEMIC FLU IPC GUIDANCE INTO COVID-19 VERSION
DHSC has provided NHSE with an adapted pandemic influenza IPC guidance document as this was urgently required. The document will be reviewed by DHSC and then circulated to NERVTAG for review. Time frame to be clarified by DHSC.
THE POTENTIAL FOR REINFECTION WITH SARS-COV-2
NERVTAG discussed the evidence around reinfection/short term sterilising immunity. Concerns were raised that the length of immunity is unclear. Evidence from endemic coronaviruses is that after a mild infection antibody response may wane and individuals can become re-infected and shed further virus. Three months may be a reasonable point after which susceptibility due to waning immunity may occur in those who suffered a mild initial infection.
Members agreed that the novel nature of SARS-CoV-2 means that immune response may be more robust than for seasonal coronaviruses.
Members agreed that although there is considerable uncertainty, reinfection is a possibility that should be considered in modelling and longitudinal studies to identify reinfections are recommended.
High Consequence Infectious Disease (HCID)
Advisory Committee for Dangerous Pathogens (ACDP) and SAGE have declassified COVID-19 and it is no longer a HCID.
I have looked through the SAGE minutes and can find no reference to them declassifying the virus. These minutes were only made available after legal action by Simon Dolan.
Concerns were raised regarding the case definition for self-isolation. Fever or cough may not cover those with other common symptoms such as myalgia. Information from the FF100 system and CO-CIN study may help inform this more.
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1.1 The Chair welcomed everyone to the meeting and thanked them for joining the meeting at short notice. Apologies were received from those listed above.
2 Adaption of the pandemic flu IPC guidance into COVID-19 version
2.1 The Chair introduced the topic with some background information. The draft pandemic flu infection, prevention and control (IPC) guidance was signed off by NERVTAG towards the end of last year and was in the process of finalisation and publication.
2.2 The Chair proposed there were three areas for consideration with the IPC document:
• Whether the statements in the document are accurate and evidence based
• Whether the document is internally consistent
• Whether the document is externally consistent with advice already given regarding COVID-19.
2.3 JVT commented that he has sent a revised version to the NHS yesterday as a matter of urgency. LR noted that there is another version that may need to be included. LR agreed to review JVT’s version and make any required changes to consolidate the documents.
2.4 It was proposed that the version sent to the NHS would remain active for the time being, while LR reviewed a consolidated version. If there were no major differences, the document would not need to come to NERVTAG however, if the consolidated document was quite different, this could be reviewed by NERVTAG via correspondence. The NERVTAG agreed version would then replace the original NHS version as the approved guidance.
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2.5 JVT noted that the guidance was needed to help relieve pressure points on the NHS in England such as decontamination of ambulances. Under the HCID specification, it takes 3 hours and guidance is required for a simpler and faster method.
Action: JVT & LR to update IPC guidance document
Action: NERVTAG to review and approve IPC guidance via correspondence if required
2.6 Members discussed the recommendations for certain aerosol-generating procedures, including non-invasive ventilation (NIV) and high-flow nasal oxygen (HFNO).
2.7 JVT clarified that NIV and HFNO are still AGPs in the guidance and noted that the guidance would define what precautions to take to ensure that the procedures were undertaken safely. It is not a clinical management guidance to specify which procedures should be used.
2.8 JVT explained that given current reasonable worst case scenario planning, there may be no other option but to use NIV, the issue is how to use this safely. There are also concerns regarding oxygen supplies and there would not be any clinical superiority for HFNO over other NIVs. [This was previously advised by the NERVTAG NIV and nosocomial transmission subcommittee]
2.9 Members noted that the guidance is recommending the use of fluid resistant surgical masks (FRSM) outside of AGP hotspots as per pandemic flu as opposed to the HCID recommendations of FFP3 respirators.
2.10 DHSC noted that they are moving towards FRSM over FFP3 (face masks) and members discussed the argument for the reclassification of COVID-19 from a high consequence infectious disease (HCID) by the Advisory Committee on Dangerous Pathogens (ACDP). JVT agreed to discuss this issue with Professor Tom Evans (ACDP Chair) with the recommendation from NERVTAG that classification as an HCID needs to be urgently reconsidered by ACDP.
2.11 JMM provided an update where JVT had spoken with Professor Tom Evans, Chair of ACDP who advised that the HCID status was discussed at the ACDP meeting and the committee were unanimous in supporting the declassification of COVID-19 as a HCID.
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3 The potential for reinfection with SARS-CoV-2
3.1 The Chair introduced the paper kindly put together by Paul Kellam and Wendy Barclay on the potential for reinfection, for consideration with the susceptible, infected, recovered (SIR) models for SARS-CoV-2 epidemiological modelling. It is accepted that infection may not result in lifelong immunity based on extrapolation from other respiratory infections. The Chair noted that SPI-M are meeting on Monday and would like a view from NERVTAG on the issue of reinfection.
3.2 JE (who is also a member of SPI-M) noted the urgent question for this epidemic was whether there is evidence of any short-term sterilising immunity -can a person can be re-infected within a matter of months. A second question of longer term immunity could be addressed in due course. Members discussed whether there was going to be a second wave due to reinfection and how long the sterile immunity window was.
3.3 WB stated that the paper highlighted two studies. The first1 concerned a challenge model with human coronavirus 229E. Adults were inoculated with 229E and then again with the same strain after one year. It was found that antibody levels were raised after the first infection but then waned over the year and led to 66% (6/9) reinfection after one year when the adults were inoculated again. It was noted that those who were re-infected a year later had very mild or no symptoms.
3.4 The second2 paper was a longitudinal community based study in Kilifi, Kenya of human coronavirus epidemiology, the most relevant in the study is human coronavirus NL63. Individuals (mainly children and some adults) were found to be positive for virus shedding in March, then negative for a short period of at least 14 days and then positive again in May. The reinfection rate was 28% (43/163) and these were split into two groups; those with symptoms and those without symptoms. The majority had low viral load and no symptoms but some did become unwell with low ct values and high levels of viral shedding that were comparable to their earlier infection.
1 Callow, K.A., Parry, H.F., Sergeant, M. and Tyrrell, D.A. 1990. The time course of the immune response to experimental coronavirus infection of man. Epidemiology and Infection 105(2), pp. 435–446.
2 Kiyuka, P.K., Agoti, C.N., Munywoki, P.K., Njeru, R., Bett, A., Otieno, J.R., Otieno, G.P., Kamau, E., Clark, T.G., van der Hoek, L., Kellam, P., Nokes, D.J. and Cotten, M. 2018. Human coronavirus NL63 molecular epidemiology and evolutionary patterns in rural coastal kenya. The Journal of Infectious Diseases 217(11), pp. 1728–1739
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3.5 WB explained that the other evidence covered in the paper for seasonal coronavirus showed some evidence of people having mild symptoms and not seroconverting at all or had made antibody that waned quite rapidly within three months after infection. In summary, there is evidence that in people with mild illness, the antibody response can wane quite rapidly and there is evidence that people can get re-infected and can shed quite robust titres of virus within 2-3 months.
3.6 It was noted that most children become seropositive for seasonal coronavirus by about 6 years of age and yet adults get infected by seasonal coronaviruses, which account for 20-25% of common cold illnesses. It is presumed that these adults would have been infected by seasonal coronaviruses as children. However, this point is related to more long-term duration of immunity.
3.7 PO noted that the immunology is similar to Respiratory Syncytial Virus (RSV) where you can get re-infected by the same strain.
3.8 Members discussed the possibility of antibody-dependent enhancement (ADE) for SARS-CoV-2. PO noted that ADE has been demonstrated in feline coronavirus when vaccines were attempted for feline peritonitis, however the mechanisms for this is unclear.
3.9 MZ noted that with regards to modelling, the immunological responses may be different for a virus that is well adapted to humans compared with a new virus. This needs to be considered when looking at reinfection.
3.10 Members are only aware of one report from Japan of a possible reinfection with COVID-19. JE agreed to check on the details of the case. Members discussed whether waxing and waning of the viral load could be mistaken for reinfection.CR noted that data presented to WHO also suggested that viral loads could fluctuate. It was noted that fluctuations are not uncommon with other pathogens and caution should be taken due to the number of uncertainties when considering potential reinfection.
Action: JE to check on details of the reported reinfection case
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3.11 PH suggested that it may be useful to do a sensitivity analysis of models to assess the impact of assuming a subset of patients with mild disease could be reinfected after a certain period. Members discussed whether 80 days (the second paper mentioned above) was appropriate to use as a meaningful threshold for reinfection in the model. WB noted that 80 days’ threshold was when there was evidence for robust viral shedding that correlated with getting full genome sequences versus not. There was evidence of apparent reinfection at 20, 30, and 40 days after initial infection but it is difficult to separate this from the waxing and waning effects that members have described or whether this was a result of continuous shedding. However, WB noted that at 80 days was a meaningful threshold as this is when robust shedding has been observed and therefore may lead to onward transmission.
3.12 Members discussed whether it might be plausible for the virus to, for example, peak in the UK in June 2020 and then have a resurgence in November 2020 through reinfection. This scenario would need to be answered by the modellers taking into careful consideration the different parameters needed. There should be consideration of the fraction of individuals who lose immunity, the rate of immunity loss and the infectiousness of the second infection. It was discussed whether data from China could be useful however the data quality from China has been varied and members thought that the data now being produced outside of China could be better, provided there are good studies following people who have had a known infection and whether they subsequently get re-infected.
3.13 WB noted that it would be very useful if there was a longitudinal study that could be undertaken to measure antibody levels. This could provide evidence of whether antibody levels wax and wane or are maintained over 60-80 days.
3.14 The Chair summarised two recommendations; one to ask JE to review Wendy’s paper to determine the parameters to be used with modelling; and secondly to recommend that appropriate studies are in place, such as a case cohort study with serial serological sampling (for antibody levels) and swabbing if they become unwell (to identify reinfection). It was noted that different scenarios could be considered as this was a novel virus and that reasonable worst-case scenario modelling needs to be undertaken.
Action: JE to determine modelling parameters and check on studies
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3.15 NERVTAG agreed that the fact this is a novel virus may be important for modelling, but that it cannot confirm or exclude the possibility of reinfection based on the limited data available. However the data are sufficient for the committee to recommend modelling of the scenario of reinfection.
3.16 Members discussed protocols already underway for the follow up of cases and other potential vehicles for obtaining data. It was noted that mild cases should be followed as well as hospitalised cases. It was suggested that the First Few 100 (FF100) cohort could be followed or an extension to the Clinical Characterisation Protocol (CCP) as well as planned household and serological studies being undertaken by PHE. The FF100 was noted as being potentially in a particularly good position to follow up as these are the first few hundred that were infected in the UK. PH noted that the milder, community cases will probably be the most informative as these would represent the experience of the majority of cases.
3.17 JVT and PH agreed to take the minutes and points raised at today’s meeting to SPI-M (Scientific Pandemic Influenza Group – Modelling) and then through to SAGE.
3.18 Members discussed the recent paper regarding the possibility of two variant strains. It was noted that the data set was limited and there were substantial overclaims within the paper. It needs to be understood whether viral sequence changes affect the antibody recognition of the virus. Very little antigenic mapping data is available for seasonal coronaviruses.
3.19 NERVTAG agreed to review antibody-dependent enhancement. WB, PO & MZ were tasked with drawing together a paper on this topic for consideration at the next NERVTAG meeting.
4 AOB and Next Meeting
4.1 The Chair noted the large number of recent meetings. It was proposed that the next meeting would focus on major scientific questions, such as antibody-dependent enhancement.
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4.2 JE raised an issue with the new case definition for the current self-isolation guidelines. There was concern that the phraseology might mean that a number of individuals with the virus may not meet the definition. JE was working off a recent paper3 that could mean that 1 in 4 cases could be missed if the criteria of only a cough and/or fever are used and this is if there was 100% compliance to the current definition, which is unlikely.
4.3 Members discussed the other major symptoms associated with infection, such as myalgia. It was noted that with the FF100 cases the main symptoms were cough, fatigue, fever and muscle ache. Similar symptoms were recorded in the CO-CIN study. The Chair asked for details to be provided from both studies to determine if the case definition is fit for purpose.
4.4 The next meeting would take place on Friday 20th March to cover major scientific questions.
3 Bi,Q et al. 2020 Epidemiology and Transmission of COVID-19 in Shenzhen China: Analysis of 391 cases and 1,286 of their close contacts, medRxiv 2020.03.03.20028423; doi: https://doi.org/10.1101/2020.03.03.20028423
SAGE also had a meeting on the 13th March, this is where we find Neil Ferguson. Van-Tam was also in on the meeting. There are no timings, and no mention of the ACDP decision. Either the meeting was held before the ACDP and NERVTAG meetings, or after, in which case the decision from the ACDP was omitted. There was also no mention of the decision in the subsequent meeting on the 16th March.
The next meeting of the ACDP was held on 1st April 2020. There is no mention of their decision to declassify the virus at their meeting on the 13th March. Usually, a meeting would start with a review of the minutes of the previous meeting and an update on the action points from it.
ADVISORY COMMITTEE ON DANGEROUS PATHOGENS
COVID -19 meeting held on Wednesday 01st April, 12:00 – 13:00am.
Thomas Evans (Chair)
Gee Yen Shin
Ian Brown (APHA)
Christine Middlemiss (UK Chief Veterinary Officer)
Heather Payne (Public Health Wales)
Helen Roberts (Defra)
Giri Shankar (Public Health Wales)
Observers/Assessors were present from the Health and Safety Executive (HSE), Public Health Wales, Scottish Government, Department for Environment, Food and Rural Affairs (Defra), Animal and Plant Health Agency (APHA), Public Health England (PHE).
Apologies received from Members: Michael Jacobs, Dan Tucker, Observers: Naresh Chada
1.0 Chairman’s opening remarks, welcomes and apologies
The Chair welcomed all attendees to this urgent meeting convened to discuss the potential of human to animal transmission of SARS-CoV-2.
2.0 The potential for human to animal transmission of SARS-CoV-2 and the likelihood of onwards transmission
The Chair welcomed the Chair of HAIRS Dr Helen Roberts (Defra) to provide a background on the current situation and risk assessments for pet and livestock exposure to SARS-CoV-2.
The Chair of HAIRS noted that HAIRS have been continuously monitoring and discussing the evolving COVID-19 situation, specifically the risk posed by animals. The risk assessment for companion and livestock animals has recently been updated in light of the new change in transmission status of COVID-19 in the UK to ‘sustained community transmission’. This continued human-to-human transmission across the UK offers the opportunity to widen the evidence base with increasing
COVID-19 testing occurring. Around the world, evidence resulting from COVID-19 testing of humans and animals alike has also been made publicly available. In Hong Kong, an announcement was made detailing that two dogs had tested positive for SARS-CoV-2, this is similar to a report from Belgium where a suspected case of SARS-CoV-2 was also identified in a cat, seen in ACDP_COVID-19_03_P01.
The updated risk assessments highlight that exposure from infected humans to companion animals is ‘high’, however the risk of the animal replicating the virus and becoming infectious is ‘very low’. The dogs in Hong Kong found to be positive for SARS-CoV-2 were confirmed via repeat nasal swabs, with one of the dogs also testing positive through an unvalidated serology test. Nevertheless, the Chair of HAIRS noted that even in the case of a positive oral/nasal swab from a companion animal, it cannot be said that the animal is infectious. All companion animals that have tested positive for SARS-CoV-2 have shown no clinical signs associated with a coronavirus-like infection that would typically be expected. This is with the exception of the Belgian cat which displayed symptoms (diarrhoea, respiratory distress and vomiting) around one week after its owner became ill with COVID-19. However, it must be considered that unlike the animals in Hong Kong which were tested for SARS-CoV-2 on several (5) occasions in quarantine, the Belgian cat was tested only once from a faecal sample inside its household where there is potential for environmental contamination.
The Committee commented that evaluating the risk of animals with limited data is extremely complex. The Chair of HAIRS noted that to widen this limited knowledge base we can draw on SARS-CoV knowledge from the 2002 – 2003 outbreak. During SARS-CoV outbreak viral RNA was identified in cats and dogs from the residential block, Amoy Gardens where many humans were infected with SARS-CoV. However, no other evidence during this outbreak emerged from the countries also affected such as Canada, the USA or Australia. Experimental SARS-CoV work where animals were deliberately infected with the virus showed that cats and ferrets could be infected under experimental conditions. Therefore, the risk assessment devised for SARS-CoV-2 reflects this evidence, but a new paper published this morning (not peer reviewed) suggests that dogs, pigs, ducks and geese are unlikely to replicate the virus in comparison to cats and ferrets which tested positive for the virus and were capable of transmitting to other animals in the experimental environment.
Ian Brown (APHA Lead Virologist) noted that from a virologist’s perspective the lack of data is problematic when trying to make any conclusive statements about the risk posed by animals. However, it is important to note that despite droplet transmission easily demonstrated between animals, even with high doses, viral replication is rare. The natural exposure of SARS-CoV-2 to cats is more likely to lead to infection than with most other animals. (as per an episode of the Simpsons ! https://www.youtube.com/watch?v=0rDDXGr5nUM ) This stance is representative of a global understanding of SARS-CoV-2 and its association with animals.
The Committee questioned the extent of the detail outlined in current public guidance on companion animals. There is currently no specific guidance in the UK on animal care in a COVID-19 positive household, primarily due to uncertainty surrounding the assumptions that would have to be included in the guidance e.g. the potential for animal fur to be a fomite. However, in light of the animal cases in Hong Kong and Belgium guidance may need to be updated to reflect this emerging evidence. It is imperative to keep the response proportionate to the risk when releasing any new guidance on companion animals to the general public as it may lead to the abandonment of many pets and widespread animal welfare issues, previously seen in Hong Kong. Thus, there is a need for continued emphasis that at present human- to -human transmission is the most significant transmission route for COVID-19 and animals have negligible significance in comparison. The Committee distinguished that detailed specialist advice for the veterinary community was important, but not for the public based on the current evidence.
The Committee also discussed the Animal and Plant Health Agency (APHA) testing capacity for COVID-19. There is currently a test available that has been funded by Defra. Systematic sampling of animals from COVID-19 positive households would help to improve the evidence base. However, at present there is not capacity to carry out this testing in a robust manner.
Finally, the committee asked about the COVID-19 risk from meat and food. Helen noted that the FSA have completed a risk assessment on meat and dairy products as well as packaging of food and have concluded that food poses a negligible risk. There is no evidence that livestock is affected or involved in the current COVID-19 pandemic. The only risk there appears to be is from the contamination of food packaging/plastics from human contamination, if SARS-CoV-2 is able to survive long enough on the package surface.
The Chair felt it important to emphasise here that the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) is leading on this incident to ensure a clear scientific pathway. (because they didn’t like our decision to declassify the virus !!)
To conclude, ACDP endorses the current SARS-CoV-2 pet and livestock risk assessments issued by Defra/APHA, whilst acknowledging that the evidence base is very limited. Currently ACDP do not feel that there is a significant contribution of companion animals to the potential spread of SARS-CoV-2 to humans.
ACTION: ACDP Chair to circulate a statement to the Chair of HAIRS to support and strengthen the scientific basis of this risk assessment for both the veterinary community and the general public.
3.0 Any other business
The role of private laboratories who have the capacity to process SARS-CoV-2 samples now offering their services was questioned by the Committee. Specifically, concerns were raised over the regulation of these laboratories. It was noted that the Health and Safety Executive (HSE) are working closely with a number of these facilities to bring them online using collaborative guidance published by Public Health England (PHE). There are minimum legal requirements in place for these laboratories to offer testing services; however, close regulation of these facilities is not currently possible. To remedy this situation, assurances for safe and appropriate working practices with SARS-CoV-2 material has been asked of these laboratories.
The Chair noted that although the potential for human to animal transmission of SARS-CoV-2 does not appear to be a significant issue at the moment, ongoing monitoring is needed. The Chair thanked everyone for their invaluable contributions to the meeting and for their ongoing support to the COVID-19 pandemic.