key: cord-300041-1d9xu4ts
authors: Chen, Sharon C-A; Rawlinson, William D.
title: Focus on SARS-CoV-2 and COVID-19
date: 2020-10-08
journal: Pathology
DOI: 10.1016/j.pathol.2020.09.010
sha: 
doc_id: 300041
cord_uid: 1d9xu4ts

nan

Emerging infections, particularly those that have occurred in pandemic proportions, have caused concern for governments and communities for thousands of years. Pandemic 'plague' (possibly typhus) in 430 BC in Athens during the Peloponnesian war likely killed two-thirds of the local population, whilst bubonic plague in the 14th century killed one-third of the world's population. As with many of their predecessors, these were caused by bacteria, and in true contagion-style, able to take flight in the setting of severe crowding, poor public health control, limited (if any) antimicrobial intervention, and in association with major events such as wars. The word 'quarantine', or a period or place of isolation, comes from the Italian word 'quaranta' which means 40. In the mid-1600s the Italians stopped people from disembarking from ships for 40 days if it was believed there was a disease outbreak onboard, a legacy we still embrace today.

In contrast, more recent pandemics have been dominated by viruses such as influenza H1N1 and H3N2, localised epidemics by Ebola virus, severe acute respiratory syndrome coronavirus-1 (SARS-CoV-1), MERS-CoV, and now, SARS-CoV-2, the causative agent of COVID-19. These can often be directly transferred from animals as occurs with other zoonoses, and have occurred in settings of modern public health systems, where antimicrobial agents of varying efficacy cannot be readily deployed, and in the absence of any identifiable major global event.

We welcome this collection of papers from colleagues on SARS-COV-2 and COVID-19 from both the diagnostic laboratory and clinical viewpoints. Our aim is to provide up-to-date perspectives at a national level on this significant pandemic, and lessons learned during the greater part of the current pandemic. The exponential growth in manuscripts globally on SARS-CoV-2 means that no single cross section of papers will provide all the important information. However, by having a single edition, with broad focus on human pathology of SARS-CoV-2 infection, we aim to provide the readers of Pathology with insights from different areas of COVID-19 diagnosis. These include an overview of the variety of diagnostic tools and their application as summarised by Gulholm et al., 1 together with technique-focussed articles on molecular diagnostics (Williams et al. 2 Substantive progress continues to be made in the arena of diagnostic tests for SARS-CoV-2 infection with improvements in molecular diagnostics, rapid antigen detection tests and serological assays. As for all diagnostic tests, the clinical utility will depend on clinical context and, importantly, on disease prevalence which should inform their use. Delineation of case clusters using next generation sequencing methods are critical for timely infection control and public health measures. These aspects have not been included in this mini collection but are described elsewhere. 16, 17 We conclude with two thoughts. Given the rise in cases in some regions of the Asia Pacific and their likely adverse social impact, Australia is a good position to deploy assistance if required. Branley et al. 18 have provided one example of such deployment to a remote Australian quarantine setting. We continue to be faced by the risk of pandemics and we must learn from our observations at present with SARS-CoV-2 infection, and resulting COVID-19 disease. P.G. Wodehouse wrote in 1926: 'To the thinking person nothing is more remarkable in this life than the way in which humanity adjusts itself to conditions which at their outset might well have appeared intolerable'. Our ability to tolerate, as well as learn and share in a collaborative manner new knowledge about SARS-CoV-2, and to harness this knowledge to reduce human suffering, is something of which we can be proud. Hand-in-hand, however, we must also be cognisant that science changes constantly and hence (as noted by the Honourable Mr. Justice Archie Campbell in The SARS Commission Executive Summary) 'the point is not about who is right and who is wrong… we should not be driven by the scientific dogma of yesterday or even the scientific dogma of today. We should be driven by the … principle' 18 to take every reasonable step to reduce risk of COVID-19 infection. During the coming months and years, this, together with use of knowledge in designing diagnostic tests, research into antivirals, vaccines and novel interventions will be important in how we improve the outcomes of this pandemic.

The authors state that there are no conflicts of interest to disclose.

Laboratory diagnosis of severe acute respiratory syndrome coronavirus 2

Implementation and evaluation of a novel real-time multiplex assay for SARS-CoV-2: in-field learnings from a clinical microbiology laboratory

Virus isolation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for diagnostic and research purposes

Comparative analysis of three laboratory based serological assays for SARS-CoV-2 in an Australian cohort

Head-to-head evaluation on diagnostic accuracies of six SARS-CoV-2 serological assays

Clinical evaluation of four commercial immunoassays for the detection of antibodies against established SARS-CoV-2 infection

Clinical evaluation of SARS-CoV-2 point-of-care tests

Laboratory biosafety measures involving SARS-CoV-2 and the classification as a Risk Group 3 biological agent

Sample pooling is a viable strategy for SARS-CoV-2 detection in low-prevalence settings

SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings

Accuracy amidst ambiguity: false positive SARS-CoV-2 nucleic acid tests when COVID-19 prevalence is low

The impact of viral transport media on PCR assay results for the detection of nucleic acid from SARS-CoV-2

Contamination of SARS-CoV-2 RT-PCR probes at the oligonucleotide manufacturer

Histopathology of cutaneous COVID-19 lesion: possible SARS-CoV-2 cytopathogenic effect

Is prostate infarction and acute urinary retention a possible complication of severe COVID-19 infection?

Isolation and rapid sharing of the 2019 novel coronavirus (SARS-CoV-2) from the first patient diagnosed with COVID-19 in Australia

Revealing COVID-19 transmission in Australia by SARS-CoV-2 genome sequencing and agent-based modeling

Rapid deployment of pathology services to a remote Australian quarantine setting during the COVID-19 pandemic

Toronto: The SARS Commission