INTERNATIONAL SYMPOSIUM ON COVID-19/INFECTIOUS DISEASES AND THEIR IMPLICATIONS ON SUSTAINABLE DEVELOPMENT

The ongoing Covid-19 pandemic is a once in a lifetime experience for the contemporary generations. During the first months of the worldwide epidemy most scientific attention was given to the medical, and in particular the epidemiology and virology aspects. Gradually the reciprocal impact of the environmental quality on the transmission of the virus and the effects of the lockdown to control the transmission become documented and it becomes clear that the disease and the way countries limit its transmission, also had environmental aspects and impacts on sustainability.
Sustainable development includes roughly aspects related to economy, society, and environment. The lockdown, which was installed in many countries to limit social contacts and consequently the spread of the disease, has a strong effect on the economy from local to global: In many sectors people lose their jobs, companies struggle with a decreasing profitability, and countries do not know yet how to deal with the financial craters in their budget as a consequence of the ongoing mitigation measures. A systematic 3 R (Reasons-Responses-Recommendations) study reported mainly negative effects on 13 out of the 17 UN Sustainable development goals.
Social isolation, considered the most efficient way for a population to control the spread of the SARS-Cov-2 virus, causes psycho-social problems among elderly, young people and other groups in society. It is associated with an increase in security problems and profoundly disturbs tourism and migration. The infection incidence is higher among the poor.
At the environmental side the number of and the data on affected aspects either directly by Covid-19 or indirectly through the measures to limit the infection incidence, increase fast. Of notice in the recent literature are:
 The seasonal transmission of the disease: Covid-19 depends on temperature and humidity. The virus exists during winter, but as soon as the temperature rises there is less transmission. A 1°C rise in temperature reduces transmission by 13%. The infection doubling time corelates inversely with humidity.
 Covid-19 first infects the upper respiratory tract causing dry cough and fever, and spreads afterwards progressively to the lower respiratory tract and other organs. Therefore interaction with pollutants such as PM2.5, NOx, ozone and SO2 in susceptible groups is not surprising. A minor increase of 1 microgram in PM2.5 concentration is linked with an increase in time on a ventilator in hospitalized patient and possibly an 8% increase of the Covid-19 death rate.
 Population density: a correlation study in 5 states in India showed that the corona virus spread depends on the spatial distribution of the population density in 3 of these states.
 At the same time lock-down measures resulted in drastic improvements in the air and water quality in many cities worldwide as a result of a reduction in traffic and industrial activities. This equally resulted in lower emissions of greenhouse gasses.
 The spread of the virus drives measures to use masks, gloves hand sanitizer and other protection materials. In particular the home use of these items resulted in a massive amount of (semi-) medical waste in the environment, while at the same time specific measures to deal with this problem were absent.
These data call to include an interdisciplinary, human ecological approach in the Covid-19 and related prevention strategies.

Since the UN declared the COVID-19 outbreak as a global pandemic in March 2020, the InterprofessionalResearch.Global (IPR.Global) has established a COVID-19 Taskforce to assess the global impacts of COVID-19 on interprofessional healthcare education, practice, and research, and to develop/disseminate best recommendations and guidance for our global community.
Healthcare education and practice continue to be highly disrupted by the current pandemic. In practice, the operation of providing direct care is restricted to essential services to protect patients and learners. However, telehealth has become a primary method of delivering care in which healthcare providers (HCPs) and patients experience a sudden and disruptive change in their healthcare delivery. In education, students and faculty are experiencing fragmentation in learning and collaboration considering normal class teaching and clinical/community instructions are not existed anymore. In underserved populations and countries, the situation is dire, as for example two-thirds of African institutions had to cancel or suspend their teaching last year. In fact, the pandemic revealed/widened the digital divide and inequity in accessing to services, technology, and distance learning in the global society. Only 60% of the global population has online access, and of those, many cannot afford computers, or may not have the know-how to use them.
The future of health care relies on our successful and systematic evolution out of the pandemic. The COVID-19 pandemic has placed the health care at a crossroads of either viewing it as a temporary situation that requires short-term solutions, or as a major disruption that presents opportunities for innovation for sustainable development and transformation. The abrupt transition to virtual healthcare and distance learning along with the COVID-19 restrictions have caused more than 80% of HCPs and over 70% of college level students to experience anxiety, stress, and/or burnout.
In a recent Call to Action entitled: “Building Resilience in Health Care in the time of COVID-19 through Collaboration – A Call to Action, IPR.Global urged the global healthcare education and practice communities to act strategic and bold to address the imminent threat of a parallel burnout pandemic by using system-based collaborative approach. Attention must be given to building capacity in the society through collaboration, innovation, and resilience.
The rapidly changing landscape of the health care towards digitalization and smart technology integration provides promising opportunities for innovation, collaboration, and resilience in improving patient/population care, safety, and health outcomes. In this Keynote, I will discuss the new paradigm shift in the digitalized healthcare education and practice that requires us to think and act differently using innovative, collaborative, and system-based approach in delivering healthcare practice and in developing the current and future healthcare workforce of the future.

A novel human virus called coronavirus, SARS-CoV-2 caused the disease named COVID-19 has become a pandemic disease. It causes severe respiratory tract infections in humans. It is transmitted from human to human within a incubation times between two to ten days. It is spread via droplets, contaminated hands or surfaces. In this presentation we would like to discuss about the methods of prevention against coronavirus, SARS-CoV-2.

Background. The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a pandemic of coronavirus disease 2019 (COVID-19). Antibody testing is essential to identify persons exposed to the virus and potentially predicting immunity.
Methods. 183 COVID-19 patients (68 mechanically ventilated) and 41 controls were tested for plasma IgG, IgA and IgM against the SARS-CoV-2 S1, S2, receptor binding domain (RBD) and N proteins using the MILLIPLEX® SARS-CoV-2 Antigen Panels. Plasma cytokines were measured using the MILLIPLEX® MAP Human Cytokine/Chemokine/Growth Factor Panel A.
Results. COVID-19 positive patients had high levels of IgG, IgA and IgM anti-SARS-CoV-2 antibodies against viral proteins. Sensitivity of anti-S1 IgG increased from 60% to 93% one week after symptom onset. S1-IgG and S1-IgA had specificities of 98%. Ventilated COVID-19 patients had higher antibody levels than the COVID-19 patients who were not ventilated. IgG antibody levels against S1 protein had the strongest correlation to days from symptom onset. There were no statistically significant differences in antibodies based on age. We found that patients with the highest IgG levels had the lowest viral load. Finally, there was a correlation of high plasma IL-10 with low anti-SARS-CoV-2 IgG.
Conclusions. Anti-SARS-CoV-2 antibody levels increased within days after symptom onset, achieving >90% sensitivity and specificity within one week, and were highest in patients who were ventilated. Antibody levels were inversely associated with viral load but did not differ by age. The correlation of high IL-10 with low antibody response suggests a potentially suppressive
role of this cytokine in the humoral immune response.

SARS-CoV-2 is currently causing the global COVID-19 pandemic, and understanding mechanisms that contribute to severity will aid in protection from poor outcomes. Here we report
that increased interleukin-13 (IL-13) was associated with the need for mechanical ventilation in two independent patient cohorts. In addition, patients who acquired COVID-19 while prescribed the IL-13 and IL-4 receptor blocker, Dupilumab, had less severe disease. In SARS-CoV-2 infected mice, IL-13 neutralization resulted in reduced disease severity, demonstrating a pathogenic role for this cytokine. Following IL-13 blockade, hyaluronan synthase 1, Has1 was identified as the most highly downregulated gene. Furthermore, blocking of the hyaluronan receptor, CD44, reduced mortality in infected mice, suggesting this pathway is regulated by IL-13. Understanding the role of IL-13 and hyaluronan has important implications for therapy of COVID-19 and potentially other pulmonary diseases.

There have been tremendous advances in in vitro diagnostic (IVD)(1) assays and smart technologies for the diagnosis, monitoring and management of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main IVD formats used for pandemic response of COVID-19 are real-time reverse transcriptase polymerase chain reaction (RT-PCR) and rapid viral antigen detection tests. Most rapid RT-PCR tests, such as those from Cepheid and Bosch, take about 40 min, while most rapid lateral flow immunoassay (LFIA) tests for viral antigen detection take less than 20 min. An exciting development has been the point-of-care (POC) molecular test (ID NOWTM)(2) and rapid antigen test (BinaxNOWTM COVID-19 Ag card)(3) by Abbott, which take just 5 min and 15 min, respectively. A large number of molecular & rapid antigen tests have been approved by the United States Food and Drug Administration (FDA) under emergency use authorization (EUA)(4) and are already Conformité Européenne (CE) certified. Similarly, many serology immunoassays (IAs) have also been developed for the detection of anti-SARS-CoV-2 antibodies (i.e., immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA)) produced in humans in response to SARS-CoV-2 infection. The most prominent serology IAs are automated chemiluminescent IA (CLIA), ELISA, and rapid LFIA. However, there is still an imminent need for novel POC fully-integrated IVD test that can detect multiple biomarkers involved in the early manifestation of COVID-19 using a smart readout device. Of interest will be an IVD technology enabling molecular, antigen, and antibody detection in a single platform. Various smart applications have been developed worldwide for contact tracing, which have been very useful to control the spread of COVID-19. Artificial intelligence and machine-learning have further facilitated the rapid and efficient diagnosis of COVID-19 infections. Telemedicine and digital healthcare have played a phenomenal role during the current pandemic, which has unleashed their high utility for future pandemics. The future directions in IVD, mobile healthcare and smart technologies, paving way to better health outcomes and effective pandemic response, will be presented.

The graphs of S-curves characterize the dynamics of change of entropic components depending on the process main parameters. The condition of the system stationary state is the equality or constant of the correlation between its entropy and negentropy. Such regularities are found in many phenomena and conformational interactions in physical chemistry, nature, engineering and even economy. The examples of their functional contribution are given. The possibility of objective analysis of the coronavirus regional scenario is demonstrated based on the Russian data.

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