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Abstract
Abattoirs have been risk points for the transmission of SARS-CoV-2 with far-reaching implications. We assessed abattoir workers’ knowledge and risk perceptions in line with the Health Belief Model premise, and preventive preparedness towards the COVID-19 pandemic, as well as identified factors associated with its spread at slaughterhouses. A structured questionnaire-based cross-sectional study was conducted on randomly selected workers (n=660) in 11 conveniently selected abattoirs in North-central Nigeria, between January and December 2021. Statistical analysis was performed at a 95% confidence level using OpenEpi 3.1. The majority (96.1%, n=634) of selected workers participated. Most workers (88.9%) were males, and 56.5% were married. Only 24.6% had tertiary education and 48.4% were butchers. Only 33.4% of the workers mentioned that COVID-19 can affect animals, while all (100.0%) reported that it can affect humans. Few of the workers practice handshake avoidance (46.1%), handwashing with soap and water (26.5%), use of hand sanitizer (21.3%), physical distancing (16.6%), and PPE (28.5%) as preventive measures, while the majority use face masks (76.8%). Age, gender, formal education, and occupation were significantly associated with knowledge, perceptions, and preventive practices toward COVID-19. Lack of physical distancing was more likely (OR=6.36; 95% CI: 3.76–10.76) to influence COVID-19 spread, while lack of PPE was 12 times more likely (OR=12.53; 95% CI: 8.01–19.63) to influence the spread of the disease in slaughterhouses. The study highlighted overall poor knowledge, perceptions, and preventive practices regarding the COVID-19 pandemic amongst surveyed workers. Application of the ‘One Health’ approach mitigation would assure food safety, food security, public and environmental health.
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References
- Abdelhafz, A. S., Mohammed, Z., Ibrahim, M. E., Ziady, H. H., Alorab, M., Ayyad, M., and Sultan, E.A. (2020). Knowledge, perceptions, and attitude of Egyptians towards the novel coronavirus disease (COVID-19). Journal of Community Health, 45(5):881–890.https://doi.org/10.1007/s10900-020-00827-7
- Alhaji, N.B. and Baiwa, M. (2015). Factors affecting workers’ delivery of good hygienic and sanitary operations in slaughterhouses in north-central Nigeria. Sokoto Journal of Veterinary Sciences, 13(1), 29 37. https://dx.doi.org/10.4314/sokjvs.v13i1.5
- Alhaji, N.B., Yatswako, S. and Oddoh, E.Y. (2017). Knowledge, risk perception and mitigation measures towards Ebola virus disease by potentially exposed bushmeat handlers in North-central Nigeria: Any critical gap? Zoonoses and Public Health,1–10. https://dx.doi.10.1111/zph.12384
- Alhaji,N.B,Odetokun, I.A., Lawan, M.K., Adeiza, A.M., Nafarnda, W.D., and Salihu, M.J. (2022).Risk assessment and preventive health behaviours toward COVID-19 amongst bushmeat handlers in Nigerian wildlife markets: Drivers and One Health challenge.Acta Tropica, 235, 106621. https://doi.org/10.1016/j.actatropica.2022.106621
- Austrian, K., Pinchof, J., Tidwell, J. B., White, C., Abuya, T., and Kangwana, B. (2020). COVID-19 related knowledge, attitudes, practices and needs of households in informal settlements in Nairobi, Kenya. Bulletin of World Health Organization,https://doi.org/10.2471/BLT.20.260281
- Bhatia, R. (2020). Need for integrated surveillance at human-animal interface for rapid detection & response to emerging coronavirus infections using one health approach. Indian Journal of Medical Research, 151(2 & 3), 132–135.
- Bourn, D., Wint, W., Blench, R. and Woolley, E. (1994). Nigerian livestock resources survey. World Animal Review, 78, 49–58.
- Brug, J., Aro, A.R. and Richardus, J.H. (2009). Risk perceptions and behaviour: Towards pandemic control of emerging infectious diseases: International research on risk perception in the control of emerging infectious diseases. International Journal of Behavioural Medicine,16, 3–6.
- Dean, A.G., Sullivan, K.M. and Soe, M.M. (2012). Open Source Epidemiologic Statistics for Public Health (OpenEpi), Version 2.3.1.
- Dohoo, I., Martin, W. and Studahl, H. (2012). Measures of Association, in: McPike, S. M, editor. Veterinary Epidemiologic Research, (Second Eds.), University of Prince Edward Island, Charlottetown, PE, Canada, pp. 136–148.
- Durand-Moreau, Q., Adisesh, A., MacKenzie, G., Bowley, J., Straube, S., Chan, X.H.,Zelyas, N., Greenhalgh, T. (2020). What explains the high rate of transmission of SARS-CoV-2 in meat and poultry facilities? Oxford Centre for Evidence Based Medicine, 4 Jun. Retrieved from https://www.cebm.net/covid-19/what-explains-the-high-rate-of-sars-cov-2-transmissionin-meat-and-poultry-facilities-2/ Accessed September 5, 2020.
- Dyal, J.W., Grant, M.P., Broadwater, K., Bjork, A., Waltenburg, M.A. and Gibbins, J.D. (2020). COVID-19 Among Workers in Meat and Poultry Processing Facilities—19 States, April 2020. MMWR Morbidity and Mortality Weekly Report, 69(18), 557–561. http://dx.doi.org/10.15585/mmwr.mm6918e3externalicon
- EFFAT (2020). Covid-19 outbreaks in slaughterhouses and meat processing plants. The European Federation of Food Agriculture and Tourism Union (EFFAT) Report on State of affairs and proposals for policy action at EU level, 25 June. Retrieved from https://effat.org/wp content/uploads/2020/06/EFFAT-Report-Covid-19-outbreaks-in-slaughterhouses-and-meat-packing-plants-State-of-affairs-and-proposals Accessed September 5, 2020.
- FAO (2020). World food prices drop in March. In: FAO - News Article, 2 April, Rome. Retrieved from http://www.fao.org/news/story/en/item/1269050/icode/ Accessed September 5, 2020.
- Farag, E.A.B.A., Reusken, C.B.E.M., Haagmans, B.L., Mohran, K.A., Raj. V.S. and Pas, S.D. (2015). High proportion of MERS-CoV shedding dromedaries at the slaughterhouse with a potential epidemiological link to human cases, Qatar 2014. Infection Ecology and Epidemiology, 5(1), 28305. http://dx.doi.org/10.3402/iee.v5.28305
- Gorbalenya, A.E., Baker, S.C., Baric, R.S., de Groot, R.J., Drosten, C., Gulyaeva, A.A., et al. (2020). The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nature Microbiology, 5(4), 536–544.https://doi.org/10.1038/s41564-020-0695-z
- Gralinski, L.E. and Menachery, V.D. (2020). Return of the coronavirus: 2019-nCoV. Viruses, 12(2), 135. https://doi.org/10.3390/v12020135
- Janz, N.K. and Becker, M.H. (1984). The health belief model: A decade later. Health Education and Behaviour,11(1), 1–47.
- Laranjo, L. (2016). Social Media and Health Behavior Change. Participatory Health Through Social Media, 83–111. http://dx.doi.org/10.1016/B978-0-12-809269-9.00006-2
- Leppin, A. and Aro, A.R. (2009). Risk perceptions related to SARS and avian influenza: Theoretical foundations of current empirical research. International Journal of Behavioural Medicine, 16(1), 7–29.https://doi.org/10.1007/s12529-008-9002-8
- Leroy, E.M., ArGouilh, M. and Brugere-Picoux, J. (2020). The risk of SARS-CoV-2 transmission to pets and other wild and domestic animals strongly mandates a one-health strategy to control the COVID-19 pandemic. One Health. 10, 100133.
- Lu, H., Stratton, C.W. and Tang, Y.W. (2020). The outbreak of pneumonia of unknown etiology in Wuhan China: the mystery and the miracle. Journal of Medical Virology, 92(4), 401–402.https://doi.org/10.1002/jmv.25678
- McNamara, T., Richt, J.A. and Glickman, L. (2020). A critical needs assessment for research in companion animals and livestock following the pandemic of COVID-19 in humans. Vector Borne Zoonotic Disease, 20(6). https://doi.org/10.1089/vbz.2020.2650
- Middleton, J., Reintjes R. and Lopes, H. (2020). Meat plants—a new front line in the covid-19 pandemic. These businesses failed in their duty to workers and the wider public health. British Medical Journal, 370, m2716. http://dx.doi.org/10.1136/bmj.m2716
- Munir, K., Ashraf, S., Munir, I., Khalid, H., Muneer, M.A., Mukhtar, N., Ashraf, S.A., Imran, M.A., Chaudhry, U., Zaheer, M.U., Arshad, M., Munir, R., Ahmad, A. and Zhao, X. (2020) Zoonotic and reverse zoonotic events of SARS-CoV 2 and their impact on global health. Emerging Microbes and Infections, 9(1), 2222 2235. http://dx.doi.org/10.1080/22221751.2020.1827984
- Murdoch, D.R. and French, N.P. 2020. COVID-19: another infectious disease emerging at the animal-human interface. New Zealand Medical Journal, 133(1510), 12–15.
- Odetokun, I.A.,Ghali-Mohammed,I.,Alhaji,N.B.,Nuhu, A.A.,Oyedele, H.A.,Ameen, S.A.,et al. (2020).Occupational health and food safety risks in Ilorin, Northcentral Nigeria: A cross-sectional survey of slaughterhouse workers.Food Protection Trends, 40(4), 241–250.
- O’Connor, A.M., Totton, S.C. and Sargeant, J.M. (2020). A rapid review of evidence of infection of pets and livestock with human-associated coronavirus diseases, SARS, MERS, and COVID-19, and evidence of the fomite potential of pets and livestock, in: Systematic Reviews for Animals & Food (SYREAF). Retrieved from http://www.syreaf.org/wpcontent/uploads/2020/04/Rapid-Review-of-pets-sfomites_3.pdf Accessed September 5, 2020.
- Pig Progress (2020). French, Dutch abattoir staff test positive for Covid-19. Retrieved fromhttps://www.pigprogress.net/Health/Articles/2020/5/Covid-19-French-and-Dutch-slaughterhouse-staff-test-positive-588262E/ Accessed September 7, 2020.
- Shaw, K.A., Szablewski, C.M., Kellner, S., Kornegay, L., Bair, P., Brennan, S., et al. (2019). Psittacosis outbreak among workers at chicken slaughter plants, Virginia and Georgia, USA, 2018. Emerging Infectious Disease, 25, 2143–5. https://dx.doi.org/10.3201/eid2511.190703
- Sheeran, P. and Abraham, S.C.S. (1996). The health belief model, in: Conner M, Norman P (eds.) Predicting Health Behaviour. Open University Press, Buckingham, UK, pp. 23– 61.
- Thrusfield, M. (2009). Veterinary Epidemiology, third ed. Blackwell Science Ltd, a Blackwell Publishing company, 9600 Garsington Road, Oxford OX4 2DQ, pp. 228–238.
- Steinberg, J., Kennedy, E.D., Basler, C., Grant, M.P., Jacobs, J.R., Ortbahn, D., et al. (2020). COVID-19 Outbreak Among Employees at a Meat Processing Facility — South Dakota, March–April 2020. MMWR Morbidity and Mortality Weekly Report, 69(31), 1015–1019. http://dx.doi.org/10.15585/mmwr.mm6931a2
- Van Doremalen, N., Bushmaker, T., Morris, D.H., Holbrook , M.G., Gamble, A., Williamson, B.N., Tamin, A., Harcourt, J.L., Thornburg, N.J., Gerber, S.I., Lloyd- Smith, J.O., de Wit, E., and Munster, V.J.(2020). Aerosol andsurface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine, 382,1564–1567. https://dx.doi.org/10.1056/NEJMc2004973
- Wei, X., Li, X., and Cui, J. (2020). Evolutionary perspectives on novel Coronaviruses identified in pneumonia cases in China. National Science Review, 7(2), 239–242. https://doi.org/10.1093/nsr/nwaa009
- WHOa (2020). Naming the coronavirus disease (COVID-19) and the virus that causes it. Geneva. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus2019/technicalguidance/aming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it Accessed August 29, 2020.
- WHOb (2020). Modes of transmission of the virus causing COVID-19: implications for IPC precaution recommendations. Geneva. https://www.who.int/newsroom/commentaries/detail/modes of transmission of virus causing covid 19 implications for ipcprecaution-recommendations Accessed August 29, 2020.
- WHOc (2020). Coronavirus disease (COVID-19) advice for the public. Geneva. URL. Geneva. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public Accessed August 29, 2020.
- WMADH (2001). World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bulletin World Health Organization. 79, 373–374.
- Yang, X., Yu, Y., Xu, J., Shu, H., Xia, J. and Liu, H. (2020). Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China:a single-centered, retrospective, observational study. Lancet Respiratory Medicine, https://doi.org/10.1016/S2213-2600(20)30079-5
- Zhang, X. (2020). Chinese livestock farms struggle under COVI-19 restrictions. IFORI Blog: Research Post, 26 March 2020. https://www.ifpri.org/blog/chinese-livestock-farms-struggle-under-covid-19-restrictions(accessed 7 September 2020).
- Zhang,R., Li, Y., Zhang, A.L., Wang, Y. and Molina, M.J. (2020) Identifying airborne transmission as the dominant route for the spread of COVID-19. Proceedings of the National Academy of Science, USA, 117 (26), 14857–14863. https://doi.org/10.1073/pnas.2009637117
- Zheng J. (2020). SARS-CoV-2: an emerging coronavirus that causes a global threat. International Journal of Biological Sciences, 16(10), 1678–1685.https://doi.org/10.7150/ijbs.45053
- Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y. and Liu, Z. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 395(10229),1054–1062. https://doi.org/10.1016/S0140-6736(20)30566-3
- Zhou, P., Yang, X.L., Wang, X.G., Hu, B., Zhang, L. and Zhang, W. (2020). A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 579 (7798), 270–273. https://doi.org/10.1038/s41586-020-2012-7
References
Abdelhafz, A. S., Mohammed, Z., Ibrahim, M. E., Ziady, H. H., Alorab, M., Ayyad, M., and Sultan, E.A. (2020). Knowledge, perceptions, and attitude of Egyptians towards the novel coronavirus disease (COVID-19). Journal of Community Health, 45(5):881–890.https://doi.org/10.1007/s10900-020-00827-7
Alhaji, N.B. and Baiwa, M. (2015). Factors affecting workers’ delivery of good hygienic and sanitary operations in slaughterhouses in north-central Nigeria. Sokoto Journal of Veterinary Sciences, 13(1), 29 37. https://dx.doi.org/10.4314/sokjvs.v13i1.5
Alhaji, N.B., Yatswako, S. and Oddoh, E.Y. (2017). Knowledge, risk perception and mitigation measures towards Ebola virus disease by potentially exposed bushmeat handlers in North-central Nigeria: Any critical gap? Zoonoses and Public Health,1–10. https://dx.doi.10.1111/zph.12384
Alhaji,N.B,Odetokun, I.A., Lawan, M.K., Adeiza, A.M., Nafarnda, W.D., and Salihu, M.J. (2022).Risk assessment and preventive health behaviours toward COVID-19 amongst bushmeat handlers in Nigerian wildlife markets: Drivers and One Health challenge.Acta Tropica, 235, 106621. https://doi.org/10.1016/j.actatropica.2022.106621
Austrian, K., Pinchof, J., Tidwell, J. B., White, C., Abuya, T., and Kangwana, B. (2020). COVID-19 related knowledge, attitudes, practices and needs of households in informal settlements in Nairobi, Kenya. Bulletin of World Health Organization,https://doi.org/10.2471/BLT.20.260281
Bhatia, R. (2020). Need for integrated surveillance at human-animal interface for rapid detection & response to emerging coronavirus infections using one health approach. Indian Journal of Medical Research, 151(2 & 3), 132–135.
Bourn, D., Wint, W., Blench, R. and Woolley, E. (1994). Nigerian livestock resources survey. World Animal Review, 78, 49–58.
Brug, J., Aro, A.R. and Richardus, J.H. (2009). Risk perceptions and behaviour: Towards pandemic control of emerging infectious diseases: International research on risk perception in the control of emerging infectious diseases. International Journal of Behavioural Medicine,16, 3–6.
Dean, A.G., Sullivan, K.M. and Soe, M.M. (2012). Open Source Epidemiologic Statistics for Public Health (OpenEpi), Version 2.3.1.
Dohoo, I., Martin, W. and Studahl, H. (2012). Measures of Association, in: McPike, S. M, editor. Veterinary Epidemiologic Research, (Second Eds.), University of Prince Edward Island, Charlottetown, PE, Canada, pp. 136–148.
Durand-Moreau, Q., Adisesh, A., MacKenzie, G., Bowley, J., Straube, S., Chan, X.H.,Zelyas, N., Greenhalgh, T. (2020). What explains the high rate of transmission of SARS-CoV-2 in meat and poultry facilities? Oxford Centre for Evidence Based Medicine, 4 Jun. Retrieved from https://www.cebm.net/covid-19/what-explains-the-high-rate-of-sars-cov-2-transmissionin-meat-and-poultry-facilities-2/ Accessed September 5, 2020.
Dyal, J.W., Grant, M.P., Broadwater, K., Bjork, A., Waltenburg, M.A. and Gibbins, J.D. (2020). COVID-19 Among Workers in Meat and Poultry Processing Facilities—19 States, April 2020. MMWR Morbidity and Mortality Weekly Report, 69(18), 557–561. http://dx.doi.org/10.15585/mmwr.mm6918e3externalicon
EFFAT (2020). Covid-19 outbreaks in slaughterhouses and meat processing plants. The European Federation of Food Agriculture and Tourism Union (EFFAT) Report on State of affairs and proposals for policy action at EU level, 25 June. Retrieved from https://effat.org/wp content/uploads/2020/06/EFFAT-Report-Covid-19-outbreaks-in-slaughterhouses-and-meat-packing-plants-State-of-affairs-and-proposals Accessed September 5, 2020.
FAO (2020). World food prices drop in March. In: FAO - News Article, 2 April, Rome. Retrieved from http://www.fao.org/news/story/en/item/1269050/icode/ Accessed September 5, 2020.
Farag, E.A.B.A., Reusken, C.B.E.M., Haagmans, B.L., Mohran, K.A., Raj. V.S. and Pas, S.D. (2015). High proportion of MERS-CoV shedding dromedaries at the slaughterhouse with a potential epidemiological link to human cases, Qatar 2014. Infection Ecology and Epidemiology, 5(1), 28305. http://dx.doi.org/10.3402/iee.v5.28305
Gorbalenya, A.E., Baker, S.C., Baric, R.S., de Groot, R.J., Drosten, C., Gulyaeva, A.A., et al. (2020). The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nature Microbiology, 5(4), 536–544.https://doi.org/10.1038/s41564-020-0695-z
Gralinski, L.E. and Menachery, V.D. (2020). Return of the coronavirus: 2019-nCoV. Viruses, 12(2), 135. https://doi.org/10.3390/v12020135
Janz, N.K. and Becker, M.H. (1984). The health belief model: A decade later. Health Education and Behaviour,11(1), 1–47.
Laranjo, L. (2016). Social Media and Health Behavior Change. Participatory Health Through Social Media, 83–111. http://dx.doi.org/10.1016/B978-0-12-809269-9.00006-2
Leppin, A. and Aro, A.R. (2009). Risk perceptions related to SARS and avian influenza: Theoretical foundations of current empirical research. International Journal of Behavioural Medicine, 16(1), 7–29.https://doi.org/10.1007/s12529-008-9002-8
Leroy, E.M., ArGouilh, M. and Brugere-Picoux, J. (2020). The risk of SARS-CoV-2 transmission to pets and other wild and domestic animals strongly mandates a one-health strategy to control the COVID-19 pandemic. One Health. 10, 100133.
Lu, H., Stratton, C.W. and Tang, Y.W. (2020). The outbreak of pneumonia of unknown etiology in Wuhan China: the mystery and the miracle. Journal of Medical Virology, 92(4), 401–402.https://doi.org/10.1002/jmv.25678
McNamara, T., Richt, J.A. and Glickman, L. (2020). A critical needs assessment for research in companion animals and livestock following the pandemic of COVID-19 in humans. Vector Borne Zoonotic Disease, 20(6). https://doi.org/10.1089/vbz.2020.2650
Middleton, J., Reintjes R. and Lopes, H. (2020). Meat plants—a new front line in the covid-19 pandemic. These businesses failed in their duty to workers and the wider public health. British Medical Journal, 370, m2716. http://dx.doi.org/10.1136/bmj.m2716
Munir, K., Ashraf, S., Munir, I., Khalid, H., Muneer, M.A., Mukhtar, N., Ashraf, S.A., Imran, M.A., Chaudhry, U., Zaheer, M.U., Arshad, M., Munir, R., Ahmad, A. and Zhao, X. (2020) Zoonotic and reverse zoonotic events of SARS-CoV 2 and their impact on global health. Emerging Microbes and Infections, 9(1), 2222 2235. http://dx.doi.org/10.1080/22221751.2020.1827984
Murdoch, D.R. and French, N.P. 2020. COVID-19: another infectious disease emerging at the animal-human interface. New Zealand Medical Journal, 133(1510), 12–15.
Odetokun, I.A.,Ghali-Mohammed,I.,Alhaji,N.B.,Nuhu, A.A.,Oyedele, H.A.,Ameen, S.A.,et al. (2020).Occupational health and food safety risks in Ilorin, Northcentral Nigeria: A cross-sectional survey of slaughterhouse workers.Food Protection Trends, 40(4), 241–250.
O’Connor, A.M., Totton, S.C. and Sargeant, J.M. (2020). A rapid review of evidence of infection of pets and livestock with human-associated coronavirus diseases, SARS, MERS, and COVID-19, and evidence of the fomite potential of pets and livestock, in: Systematic Reviews for Animals & Food (SYREAF). Retrieved from http://www.syreaf.org/wpcontent/uploads/2020/04/Rapid-Review-of-pets-sfomites_3.pdf Accessed September 5, 2020.
Pig Progress (2020). French, Dutch abattoir staff test positive for Covid-19. Retrieved fromhttps://www.pigprogress.net/Health/Articles/2020/5/Covid-19-French-and-Dutch-slaughterhouse-staff-test-positive-588262E/ Accessed September 7, 2020.
Shaw, K.A., Szablewski, C.M., Kellner, S., Kornegay, L., Bair, P., Brennan, S., et al. (2019). Psittacosis outbreak among workers at chicken slaughter plants, Virginia and Georgia, USA, 2018. Emerging Infectious Disease, 25, 2143–5. https://dx.doi.org/10.3201/eid2511.190703
Sheeran, P. and Abraham, S.C.S. (1996). The health belief model, in: Conner M, Norman P (eds.) Predicting Health Behaviour. Open University Press, Buckingham, UK, pp. 23– 61.
Thrusfield, M. (2009). Veterinary Epidemiology, third ed. Blackwell Science Ltd, a Blackwell Publishing company, 9600 Garsington Road, Oxford OX4 2DQ, pp. 228–238.
Steinberg, J., Kennedy, E.D., Basler, C., Grant, M.P., Jacobs, J.R., Ortbahn, D., et al. (2020). COVID-19 Outbreak Among Employees at a Meat Processing Facility — South Dakota, March–April 2020. MMWR Morbidity and Mortality Weekly Report, 69(31), 1015–1019. http://dx.doi.org/10.15585/mmwr.mm6931a2
Van Doremalen, N., Bushmaker, T., Morris, D.H., Holbrook , M.G., Gamble, A., Williamson, B.N., Tamin, A., Harcourt, J.L., Thornburg, N.J., Gerber, S.I., Lloyd- Smith, J.O., de Wit, E., and Munster, V.J.(2020). Aerosol andsurface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine, 382,1564–1567. https://dx.doi.org/10.1056/NEJMc2004973
Wei, X., Li, X., and Cui, J. (2020). Evolutionary perspectives on novel Coronaviruses identified in pneumonia cases in China. National Science Review, 7(2), 239–242. https://doi.org/10.1093/nsr/nwaa009
WHOa (2020). Naming the coronavirus disease (COVID-19) and the virus that causes it. Geneva. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus2019/technicalguidance/aming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it Accessed August 29, 2020.
WHOb (2020). Modes of transmission of the virus causing COVID-19: implications for IPC precaution recommendations. Geneva. https://www.who.int/newsroom/commentaries/detail/modes of transmission of virus causing covid 19 implications for ipcprecaution-recommendations Accessed August 29, 2020.
WHOc (2020). Coronavirus disease (COVID-19) advice for the public. Geneva. URL. Geneva. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public Accessed August 29, 2020.
WMADH (2001). World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bulletin World Health Organization. 79, 373–374.
Yang, X., Yu, Y., Xu, J., Shu, H., Xia, J. and Liu, H. (2020). Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China:a single-centered, retrospective, observational study. Lancet Respiratory Medicine, https://doi.org/10.1016/S2213-2600(20)30079-5
Zhang, X. (2020). Chinese livestock farms struggle under COVI-19 restrictions. IFORI Blog: Research Post, 26 March 2020. https://www.ifpri.org/blog/chinese-livestock-farms-struggle-under-covid-19-restrictions(accessed 7 September 2020).
Zhang,R., Li, Y., Zhang, A.L., Wang, Y. and Molina, M.J. (2020) Identifying airborne transmission as the dominant route for the spread of COVID-19. Proceedings of the National Academy of Science, USA, 117 (26), 14857–14863. https://doi.org/10.1073/pnas.2009637117
Zheng J. (2020). SARS-CoV-2: an emerging coronavirus that causes a global threat. International Journal of Biological Sciences, 16(10), 1678–1685.https://doi.org/10.7150/ijbs.45053
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y. and Liu, Z. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 395(10229),1054–1062. https://doi.org/10.1016/S0140-6736(20)30566-3
Zhou, P., Yang, X.L., Wang, X.G., Hu, B., Zhang, L. and Zhang, W. (2020). A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 579 (7798), 270–273. https://doi.org/10.1038/s41586-020-2012-7