key: cord-0843104-yeam2brv
authors: Mortimer, Philip P
title: Rational procedures for this and the next virus pandemic
date: 2021-07-06
journal: Rev Med Virol
DOI: 10.1002/rmv.2266
sha: 03f7c6096f55ec33ac0d88c9b1416f38519c7165
doc_id: 843104
cord_uid: yeam2brv

nan

Here are the responses, informed by several decades of virological experience that should characterise further action against Covid-19 and any future virus pandemic:

1. Identify the virus and establish the natural history of its infection in humans and any other animal species, as well as any insect involved in its transmission. It can be seen to be in the interests of the virus as well as its hosts to survive, so with increasing population immunity the virus may well tend towards greater transmissibility and less virulence. SARS-2 virus may well follow this pattern.

2. Assess the range of severity of illness associated with the virus, and the susceptibility of those humans who might be vulnerable to it through age, pre-existing illness, pregnancy, particular ethnicity or restricted access to health care.

3. Apply to the virus genomic (e.g., polymerase chain reaction [PCR] ) and immunologic laboratory tests that have been regulated and standardised with regard to their sensitivity and specificity. Commercial point-of-care SARS-2 antigen tests 1 have now attained an accuracy that allows them rather than PCR to be the marker of infectiousness, at least for those with symptoms. This advance should now be transforming the UK's and other countries' present response to the continuing threat from the Covid-19 virus.

4. Search for antiviral therapy that will interrupt the growth of the virus, and use it promptly while virus replication and excretion is still at its height (recognising that this may not coincide with immunopathological phases of the disease). This will both shorten the duration of the associated illness and suppress infectiousness. As far as possible, the treatment should be made available within the community, avoiding hospital admission.

It may be possible to use it to prevent infection in those known to have been exposed to infection. 

Comparison of seven commercial SARS-CoV-2 rapid point-of-care antigen tests: a single-centre laboratory evaluation study