Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): Infectious substances Pathogen Safety Data Sheet

For more information on SARS-CoV-2, see the following:

Section I: Infectious agent

Name

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)

Agent type

Virus

Taxonomy

Family

Coronaviridae

Genus

Betacoronavirus

Species

Severe acute respiratory syndrome coronavirus

Subspecies/strain/clonal isolate

Synonym or cross reference

Formerly known as 2019 novel coronavirus (2019-nCoV); also referred to as the virus responsible for COVID-19 or the COVID-19 virus

Characteristics

Brief description

SARS-CoV-2 is an enveloped, positive-sense, single-stranded RNA virus^{Footnote 1}. Virions range in size from 60 to 140 nm ^{Footnote 2}. Coronavirus virions have distinctive club-shaped spikes on their surface, which give the virions the appearance of a solar corona, hence the viral family name^{Footnote 3}.

The SARS-CoV-2 genome varies in size from 29.8 kB to 29.9 kB and has 12 open reading frames, which encode 27 proteins including four structural proteins: the surface/spike (S) protein for binding to the ACE2 receptor on the host cell, the envelope (E) protein, the membrane (M) glycoprotein, and the nucleocapsid (N) phosphoprotein^{Footnote 4}. Two SARS-CoV-2 proteases are critical for virus replication^{Footnote 5}.

Section II: Hazard identification

Pathogenicity and toxicity

COVID-19, the disease caused by SARS-CoV-2, may range in severity from asymptomatic to fatal^{Footnote 6}. It is estimated that approximately one quarter to one third of SARS-CoV-2 infections are asymptomatic^{Footnote 7}^{Footnote 8}. Children and adolescents younger than 19 years of age are often asymptomatic, and when symptomatic, usually have fewer and milder symptoms compared to adults >25 years old ^{Footnote 9}. Although the risk of severe COVID-19 disease and death increases with age, asymptomatic infection is common in the elderly^{Footnote 10}^{Footnote 11}.

Common COVID-19 symptoms include chills, fever, new or worsening cough, fatigue, myalgia, headache, and gastrointestinal symptoms (e.g., nausea, vomiting and diarrhea)^{Footnote 12}. Less frequent symptoms include shortness of breath/difficulty breathing, sore throat, and loss of smell and/or taste. Some individuals may experience rare symptoms such as skin and/or eye manifestations. SARS-CoV-2 may also impact organ systems besides the respiratory system to cause a multitude of extrapulmonary symptoms that may result in fatal extrapulmonary complications^{Footnote 13}^{Footnote 14}. These non-respiratory systems include the cardiovascular, renal, gastrointestinal, hepatobiliary, endocrine, nervous, integumentary, and hematological and immune systems.

SARS-CoV-2 infection, in certain cases, can also cause multisystem inflammatory syndrome in children (MIS-C), a rare, sometimes fatal, post-infectious condition with features of toxic shock syndrome and Kawasaki disease^{Footnote 15}. A similar syndrome, multisystem inflammatory syndrome in adults (MIS-A), has also been described^{Footnote 16}. Both syndromes typically occur two to six weeks following the onset of typical COVID-19 symptoms^{Footnote 15}^{Footnote 16}.

Another type of syndrome that may develop after the acute phase of illness is 'long COVID', also known as 'post-COVID-19 condition' and 'post-acute COVID-19 syndrome'^{Footnote 17}^{Footnote 18}. This syndrome usually occurs 3 months after the onset of COVID-19, with symptoms lasting for at least 2 months^{Footnote 17}. Common symptoms include, but are not limited to, fatigue, shortness of breath, and cognitive dysfunction, which can impact everyday functioning.

COVID-19 mortality rates vary widely by country for reasons including differences in population demographics, health care capacity, and the effectiveness of the public health interventions implemented to reduce SARS-CoV-2 transmission^{Footnote 19}. Global SARS-CoV-2 mortality analyses, including case fatality rates, which vary nationally from 0.1 to 19.6%, are available on the Johns Hopkins University and Medicine Coronavirus Resource Centre's Mortality Analyses web page.

SARS-CoV-2 can infect a range of animal species with disease severity ranging from asymptomatic to fatal. Outbreaks in farmed mink, an economically important animal, have occurred in Canada, the US and in multiple European countries^{Footnote 20}^{Footnote 21}. Disease severity ranges from asymptomatic to fatal in infected mink. Clinical disease in infected dogs, domestic cats, and big cats in zoos also ranges from asymptomatic to symptomatic with respiratory and/or digestive symptoms^{Footnote 22}^{Footnote 23}. Furthermore, mild respiratory symptoms have been reported in infected zoo gorillas^{Footnote 24}. In addition, infected pet ferrets have been reported to be either asymptomatic, or to have mild or severe gastrointestinal symptoms^{Footnote 25}^{Footnote 26}^{Footnote 27}.

Predisposing factors

Advanced age is a risk factor for severe disease^{Footnote 10}^{Footnote 28}^{Footnote 29}. The risk of severe illness increases for people in their 50s and older, with those 85 years of age and older at the greatest risk of severe illness^{Footnote 29}. Medical conditions that can also increase the risk of severe disease include asthma (moderate to severe) and/or other chronic lung diseases, cancer, cystic fibrosis, diabetes, Down syndrome, epilepsy, cardiovascular disease, kidney disease, liver disease, dementia or other neurological disease, obesity, pregnancy, sickle cell disease, stroke or cerebrovascular disease, thalassemia, a history of smoking, substance use disorders, and being immunosuppressed/immunodeficient^{Footnote 12}.

In mink, pregnancy, advanced age, and breed may increase the risk of severe disease^{Footnote 30}^{Footnote 31}^{Footnote 32}.

Communicability

SARS-CoV-2 is a respiratory virus that is transmitted by respiratory droplets and aerosols^{Footnote 33}. Infectious virus can be transmitted by inhaling respiratory droplets and/or aerosols; aerosols may remain suspended in the air for minutes to hours. Alternatively, respiratory droplets and/or aerosols may be deposited directly onto exposed mucous membranes in the mouth, nose or eyes by direct splashes or sprays such as those produced by coughing. Finally, respiratory droplets and/or aerosols may be deposited onto inanimate objects, which act as fomites. However, the risk of SARS-CoV-2 transmission by fomites is considered to be low^{Footnote 34}.

Furthermore, infectious virus has been detected in urine and feces, suggesting that these can transmit infection^{Footnote 35}^{Footnote 36}. In addition, epidemiological studies have concluded that SARS-CoV-2 may be transmitted via contaminated sewage, and by contaminated bioaerosols produced by plumbing connecting apartments^{Footnote 37}^{Footnote 38}^{Footnote 39}.

Vertical transmission from mother to fetus/infant is considered possible although most cases of neonatal infection appear to occur post-partum^{Footnote 40}.

SARS-CoV-2 infection may be transmitted by pre-symptomatic and asymptomatic individuals, although the extent to which such individuals transmit compared to symptomatic individuals is unknown^{Footnote 41}.

Furthermore, animal-to-animal transmission has been documented under experimental conditions for some species such as ferrets, hamsters, cats and bats^{Footnote 42}^{Footnote 43}. Furthermore, white-tailed deer appear to transmit to each other in the wild^{Footnote 44}.

Epidemiology

In early January 2020, Chinese authorities announced that they had identified a novel coronavirus as the cause of unexplained cases of viral pneumonia first reported in December 2019 in Wuhan, China^{Footnote 45}. Chinese authorities subsequently reported human-to-human transmission of this virus in Wuhan (in the province of Hubei), outside of Wuhan, and in some clusters outside of Hubei^{Footnote 46}. On January 30, 2020, the International Health Regulations (2005) Emergency Committee agreed that the outbreak met the criteria for a Public Health Emergency of International Concern given that the virus had spread to 18 other countries in which human-to-human transmission was occurring in some. On March 11, 2020, the World Health Organization (WHO) declared the SARS-CoV-2 outbreak a pandemic^{Footnote 45}. SARS-CoV-2 would eventually spread to most countries, with catastrophic public health and economic consequences. Global statistics for confirmed SARS-CoV-2 infections and deaths are available on the WHO Coronavirus (COVID-19) Dashboard.

Host range

Natural host(s)

Humans are the primary SARS-CoV-2 host^{Footnote 47}.

Other host(s)

Naturally-occurring infections have been reported in multiple feline species, pet dogs and ferrets, mink (farmed and wild), otters, beavers, white-tailed deer, hyenas, coatimundi, and gorillas^{Footnote 44}^{Footnote 48}^{Footnote 49}^{Footnote 50}^{Footnote 51}^{Footnote 52}.

Various mammalian species have been experimentally infected with SARS-CoV-2. Susceptible species, which support varying degrees of viral replication and experience varying degrees of disease severity, include non-human primates, small animal species often used in experimental studies of respiratory viruses (e.g., ferrets and hamsters), companion animals (e.g., cats), and various wild animal species (e.g., bank voles and fruit bats)^{Footnote 42}^{Footnote 43}^{Footnote 53}.

Infectious dose

The human infectious dose of SARS-CoV-2 is unknown^{Footnote 54}. Based on non-human primate research, the best estimate of the human infectious dose via the inhalation route is 36-179 viral particles (plaque forming units).

Incubation period

The estimated incubation period ranges from 2-14 days, with a median of 5-6 days from exposure to symptom onset^{Footnote 12}. However, in some individuals, especially the elderly, the incubation period may be longer^{Footnote 55}. Nonetheless, the majority of individuals who do become symptomatic will do so by 11.5 days post-infection^{Footnote 12}.

Section III: Dissemination

Reservoir

The original animal reservoir(s) that may have been responsible for transmitting SARS-CoV-2 to humans is unknown^{Footnote 56}.

Zoonosis/Reverse zoonosis

Zoonotic transmission from farmed mink to humans has been reported in the Netherlands and Denmark^{Footnote 57}^{Footnote 58}.

Reverse zoonotic transmission has occurred in multiple feline species, pet dogs and ferrets, mink (farmed and wild), otters, beavers, white-tailed deer, hyenas, coatimundi, and gorillas, following known or suspected contact with infected humans^{Footnote 44}^{Footnote 48}^{Footnote 49}^{Footnote 50}^{Footnote 51}^{Footnote 52}.

Vectors

None confirmed to date.

Section IV: Stability and viability

Drug susceptibility

Multiple antivirals and anti-SARS-CoV-2 spike protein monoclonal antibodies have been authorized for the treatment of COVID-19. Health Canada has summarized complete list of authorized drugs and vaccines for COVID-19 in Canada.

Drug resistance

SARS-CoV-2 has continued to evolve since its identification in January 2020, acquiring mutations that have at least somewhat reduced the effectiveness of vaccines and therapeutic monoclonal antibodies created against early viral spike protein sequences^{Footnote 59}^{Footnote 60}. Viral variants with mutations that reduce vaccine and/or drug effectiveness are referred to as 'Variants of Concern'.

Susceptibility to disinfectants

SARS-CoV-2 is susceptible to disinfectants having proven activity against enveloped viruses^{Footnote 61}. These disinfectants include sodium hypochlorite, i.e., bleach (1 000 parts per million [0.1%] for general surface disinfection, and 10 000 parts per million [1%] for disinfection of sample spills), 70% ethanol, 7.5% povidone‐iodine, 0.05% chloroxylenol, 0.05% chlorhexidine, and 0.1% benzalkonium chloride.

Furthermore, methanol (100% and ice-cold) and paraformaldehyde (4%) can inactivate virus in infected cells^{Footnote 62}.

Health Canada has published a list of hard-surface disinfectants with evidence for use against COVID-19.

Physical inactivation

SARS-CoV-2 can be inactivated by heating for 15 to 30 minutes at 56°C, 10 to 15 minutes at 60oC to 65°C, and 2 minutes at 98°C^{Footnote 63}. Furthermore, SARS-CoV-2 loses infectivity within 1 day at pH extremes of pH 2–3 and pH 11–12^{Footnote 64}. SARS-CoV-2 can also be inactivated by exposure to simulated sunlight representing natural sunlight (ultraviolet [UV] range of 280–400 nm), UVB radiation (280–315 nm), UVC radiation of different wavelengths (i.e., 254 nm or 200–280 nm), gamma radiation (1 Mrad), a deep ultraviolet light-emitting diode (DUV-LED; 280 ± 5 nm), cold atmospheric plasma with argon feed gas, and gaseous ozone^{Footnote 65}^{Footnote 66}^{Footnote 67}^{Footnote 68}^{Footnote 69}^{Footnote 70}^{Footnote 71}^{Footnote 72}.

Survival outside host

Studies have shown that SARS-CoV-2 can survive for extended periods at room temperature on different types of surfaces including vinyl, steel, glass, paper and polymer banknotes (up to 28 days); cotton cloth (up to 14 days); polymer surfaces (up to 13 days); plastic, face masks and latex gloves (up to 7 days); and cardboard and wood (up to 2 days)^{Footnote 73}^{Footnote 74}. The available data suggest that SARS-CoV-2 is the most resistant human coronavirus^{Footnote 74}.

Under experimental conditions, SARS-COV-2 was also shown to survive in some biological fluids (i.e., nasal mucus, sputum, saliva, tears, blood, or semen), from one to three days at 25°C/70% relative humidity (RH), for seven days at 21°C/60% RH, and for 21 days at 5°C/75% RH, but was unstable in human feces, fecal suspension, and breastmilk^{Footnote 75}.

When aerosolized, SARS-CoV-2 can be viable for at least three hours^{Footnote 76}.

Section V: First aid/medical

Surveillance

Although viral sequencing is the most definitive method for diagnosing SARS-CoV-2 infection, the cost and technical requirements of this technique limit its feasibility^{Footnote 77}. As such, the gold standard for detecting SARS-CoV-2 is the reverse transcription–polymerase chain reaction (RT-PCR) assay, which detects viral ribonucleic acid. The RT-LAMP (RT-loop mediated isothermal amplification) assay may also be used to detect viral nucleic acid. The detection of viral antigens in clinical samples can also be used for diagnosis. Virus may also be detected in tissue samples by in situ hybridization or immunohistochemistry.

Note: The specific recommendations for surveillance in the laboratory should come from the medical surveillance program, which is based on a local risk assessment of the pathogens and activities being undertaken, as well as an overarching risk assessment of the biosafety program as a whole. More information on medical surveillance is available in the Canadian Biosafety Handbook (Canadian Biosafety Handbook).

First aid/treatment

COVID-19 treatment guidelines are evolving. Treatment may include the antiviral remdesivir, oxygen therapy, airway management, steroids, and the management of septic shock, depending on disease severity, in addition to the management of co-infections^{Footnote 78}. More information can be found on the WHO living guidance for the clinical management of COVID-19 and the WHO living guideline for COVID-19 therapeutics.

SARS-CoV-2-infected pets usually have mild respiratory and/or digestive symptoms, which resolve with supportive care^{Footnote 79}. In the case of infected farmed mink, mass culling may be performed depending on the national or regional capacity to contain the outbreak and manage risks using less severe approaches^{Footnote 80}.

Note: The specific recommendations for first aid/treatment in the laboratory should come from the post-exposure response plan, which is developed as part of the medical surveillance program. More information on the post-exposure response plan can be found in the Canadian Biosafety Handbook.

Immunization

Multiple COVID-19 vaccines have been approved for the active immunization of the general population, as summarized on the COVID-19 vaccine tracker.

Veterinarian vaccines, including Carnivac-Cov and FurcoVac, have been authorized for use in various countries^{Footnote 81}^{Footnote 82}^{Footnote 83}^{Footnote 84}.

Note: More information on the medical surveillance program can be found in the Canadian Biosafety Handbook, and by consulting the Canadian Immunization Guide.

Prophylaxis

Pre-exposure prophylaxis consisting of a monoclonal antibody cocktail specific for the SARS-CoV-2 spike protein has been authorized in some jurisdictions for moderately to severely immunocompromised individuals who may not respond adequately to SARS-CoV-2 vaccines, and for individuals for whom such vaccines are contraindicated^{Footnote 85}^{Footnote 86}.

There are currently no post-exposure prophylaxis measures.

Note: More information on prophylaxis as part of the medical surveillance program can be found in the Canadian Biosafety Handbook.

Section VI: Laboratory hazards

Laboratory-acquired infections

At this time, there are no reported cases of laboratory-acquired SARS-CoV-2 infections.

Note: Please consult the Canadian Biosafety Standard and Canadian Biosafety Handbook for additional details on requirements for reporting exposure incidents. A Canadian Biosafety Guideline describing notification and reporting procedures is also available.

Sources/specimens

Diagnostic samples typically include respiratory samples such as nasopharyngeal, oropharyngeal, or nasal swabs, bronchoalveolar lavage fluid, saliva, or sputum; however, stool, urine, serum, blood and tissue samples may also be used^{Footnote 77}.

Primary hazards

Inhalation of infectious material or exposure of mucous membranes to infectious material ^{Footnote 33}

Special hazards

It has been suggested that SARS-CoV-2 could survive in the liquid nitrogen and/or in the nitrogen vapours routinely used to cryopreserve biological samples, possibly resulting in sample cross-contamination, and/or in the infection of laboratory workers^{Footnote 87}^{Footnote 88}.

Since the SARS-CoV-2 genome, which consists of positive-stranded RNA, is considered infectious, activities with intact genomic RNA pose a risk of infection, despite the absence of infectious virions^{Footnote 89}.

Section VII: Exposure controls/personal protection

Risk group classification

SARS-CoV-2 is a Risk Group 3 human pathogen and Risk Group 2 animal pathogen. Single-stranded RNA is a Risk Group 2 biological agent for humans and a Risk Group 1 biological agent for animals.

Containment requirements

Containment Level 3 facilities, equipment, and operational practices outlined in the Canadian Biosafety Standard and in the Biosafety advisory: SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) for all in vivo and in vitro activities. Non-propagative diagnostic or clinical activities can be conducted at containment level 2 with additional requirements, as specified in the Biosafety advisory: SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2).

Section VIII: Handling and storage

Spills

Allow aerosols to settle. Wearing protective clothing, gently cover the spill with absorbent paper towel and apply suitable disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up (Canadian Biosafety Handbook).

Disposal

All materials/substances that have come in contact with the infectious agent must be completely decontaminated before they are removed from the containment zone. This can be achieved by using a decontamination method that has been demonstrated to be effective against the infectious material, such as chemical disinfectants, autoclaving, irradiation, incineration, an effluent treatment system, or gaseous decontamination (Canadian Biosafety Handbook).

Storage

The applicable Containment Level 3 requirements for storage outlined in the Canadian Biosafety Standard to be followed. Containers of infectious material or toxins stored outside the containment zone should be labelled, leakproof, impact resistant, and kept either in locked storage equipment or within an area with limited access.

Section IX: Regulatory and other information

Canadian regulatory context

Controlled activities with SARS-CoV-2 require a Human Pathogens and Toxins Licence issued by the Public Health Agency of Canada. SARS-CoV-2 is not a reportable/notifiable animal disease. However, individuals are asked to immediately notify the CFIA if SARS-CoV-2 is detected in an animal. The following is a non-exhaustive list of applicable designations, regulation, or legislation:

Updated

December, 2021

Prepared by

Centre for Biosecurity, Public Health Agency of Canada.

Disclaimer

The scientific information, opinions, and recommendations contained in this Pathogen Safety Data Sheet have been developed based on or compiled from trusted sources available at the time of publication. Newly discovered hazards are frequent and this information may not be completely up to date. The Government of Canada accepts no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information.

Persons in Canada are responsible for complying with the relevant laws, including regulations, guidelines and standards applicable to the import, transport, and use of pathogens in Canada set by relevant regulatory authorities, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment and Climate Change Canada, and Transport Canada. The risk classification and related regulatory requirements referenced in this Pathogen Safety Data Sheet, such as those found in the Canadian Biosecurity Standard, may be incomplete and are specific to the Canadian context. Other jurisdictions will have their own requirements.

References

Footnote 1

Cui, J., F. Li, and Z. L. Shi. 2019. Origin and evolution of pathogenic coronaviruses. Nat. Rev. Microbiol. 17:181-192.

Return to footnote 1 referrer

Footnote 2

Zhu, N., D. Zhang, W. Wang, X. Li, B. Yang, J. Song, X. Zhao, B. Huang, W. Shi, R. Lu, P. Niu, F. Zhan, X. Ma, D. Wang, W. Xu, G. Wu, G. F. Gao, W. Tan, and China Novel Coronavirus Investigating and Research Team. 2020. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 382:727-733.

Return to footnote 2 referrer

Footnote 3

Fehr, A. R., and S. Perlman. 2015. Coronaviruses: an overview of their replication and pathogenesis. Methods Mol. Biol. 1282:1-23.

Return to footnote 3 referrer

Footnote 4

Rahimi, A., A. Mirzazadeh, and S. Tavakolpour. 2021. Genetics and genomics of SARS-CoV-2: A review of the literature with the special focus on genetic diversity and SARS-CoV-2 genome detection. Genomics. 113:1221-1232.

Return to footnote 4 referrer

Footnote 5

Chen, Y. W., C. B. Yiu, and K. Y. Wong. 2020. Prediction of the SARS-CoV-2 (2019-nCoV) 3C-like protease (3CL (pro)) structure: virtual screening reveals velpatasvir, ledipasvir, and other drug repurposing candidates. F1000Res. 9:129.

Return to footnote 5 referrer

Footnote 6

Vermund, S. H., and V. E. Pitzer. 2021. Asymptomatic Transmission and the Infection Fatality Risk for COVID-19: Implications for School Reopening. Clin. Infect. Dis. 72:1493-1496.

Return to footnote 6 referrer

Footnote 7

Alene, M., L. Yismaw, M. A. Assemie, D. B. Ketema, B. Mengist, B. Kassie, and T. Y. Birhan. 2021. Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis. PLoS One. 16:e0249090.

Return to footnote 7 referrer

Footnote 8

Oran, D. P., and E. J. Topol. 2021. The Proportion of SARS-CoV-2 Infections That Are Asymptomatic. Ann. Intern. Med. 174:1344-1345.

Return to footnote 8 referrer

Footnote 9

World Health Organization. Sept. 14, 2021. Weekly epidemiological update on COVID-19 (Edition 57). https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---14-september-2021.

Return to footnote 9 referrer

Footnote 10

Government of Canada. Aug. 31, 2021. People who are at risk of more severe disease or outcomes from COVID-19. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/people-high-risk-for-severe-illness-covid-19.html.

Return to footnote 10 referrer

Footnote 11

White, E. M., C. M. Santostefano, R. A. Feifer, C. M. Kosar, C. Blackman, S. Gravenstein, and V. Mor. 2020. Asymptomatic and Presymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection Rates in a Multistate Sample of Skilled Nursing Facilities. JAMA Intern. Med. 180:1709-1711.

Return to footnote 11 referrer

Footnote 12

Government of Canada. Jun. 17, 2021. COVID-19 signs, symptoms and severity of disease: A clinician guide. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/guidance-documents/signs-symptoms-severity.html#a3.

Return to footnote 12 referrer

Footnote 13

Gupta, A., M. V. Madhavan, K. Sehgal, N. Nair, S. Mahajan, T. S. Sehrawat, B. Bikdeli, N. Ahluwalia, J. C. Ausiello, E. Y. Wan, D. E. Freedberg, A. J. Kirtane, S. A. Parikh, M. S. Maurer, A. S. Nordvig, D. Accili, J. M. Bathon, S. Mohan, K. A. Bauer, M. B. Leon, H. M. Krumholz, N. Uriel, M. R. Mehra, M. S. V. Elkind, G. W. Stone, A. Schwartz, D. D. Ho, J. P. Bilezikian, and D. W. Landry. 2020. Extrapulmonary manifestations of COVID-19. Nat. Med. 26:1017-1032.

Return to footnote 13 referrer

Footnote 14

Zheng, K. I., G. Feng, W. Y. Liu, G. Targher, C. D. Byrne, and M. H. Zheng. 2021. Extrapulmonary complications of COVID-19: A multisystem disease? J. Med. Virol. 93:323-335.

Return to footnote 14 referrer

Footnote 15

Godfred-Cato, S., B. Bryant, J. Leung, M. E. Oster, L. Conklin, J. Abrams, K. Roguski, B. Wallace, E. Prezzato, E. H. Koumans, E. H. Lee, A. Geevarughese, M. K. Lash, K. H. Reilly, W. P. Pulver, D. Thomas, K. A. Feder, K. K. Hsu, N. Plipat, G. Richardson, H. Reid, S. Lim, A. Schmitz, T. Pierce, S. Hrapcak, D. Datta, S. B. Morris, K. Clarke, E. Belay, and California MIS-C Response Team. 2020. COVID-19-Associated Multisystem Inflammatory Syndrome in Children - United States, March-July 2020. MMWR Morb. Mortal. Wkly. Rep. 69:1074-1080.

Return to footnote 15 referrer

Footnote 16

Patel, P., J. DeCuir, J. Abrams, A. P. Campbell, S. Godfred-Cato, and E. D. Belay. 2021. Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults: A Systematic Review. JAMA Netw. Open. 4:e2126456.

Return to footnote 16 referrer

Footnote 17

World Health Organization. Oct. 6, 2021. A Clinical Case Definition of Post COVID-19 Condition by a Delphi Consensus. https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1.

Return to footnote 17 referrer

Footnote 18

Nalbandian, A., K. Sehgal, A. Gupta, M. V. Madhavan, C. McGroder, J. S. Stevens, J. R. Cook, A. S. Nordvig, D. Shalev, T. S. Sehrawat, N. Ahluwalia, B. Bikdeli, D. Dietz, C. Der-Nigoghossian, N. Liyanage-Don, G. F. Rosner, E. J. Bernstein, S. Mohan, A. A. Beckley, D. S. Seres, T. K. Choueiri, N. Uriel, J. C. Ausiello, D. Accili, D. E. Freedberg, M. Baldwin, A. Schwartz, D. Brodie, C. K. Garcia, M. S. V. Elkind, J. M. Connors, J. P. Bilezikian, D. W. Landry, and E. Y. Wan. 2021. Post-acute COVID-19 syndrome. Nat. Med. 27:601-615.

Return to footnote 18 referrer

Footnote 19

Chaudhry, R., G. Dranitsaris, T. Mubashir, J. Bartoszko, and S. Riazi. 2020. A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes. EClinicalMedicine. 25:100464.

Return to footnote 19 referrer

Footnote 20

Fenollar, F., O. Mediannikov, M. Maurin, C. Devaux, P. Colson, A. Levasseur, P. E. Fournier, and D. Raoult. 2021. Mink, SARS-CoV-2, and the Human-Animal Interface. Front. Microbiol. 12:663815.

Return to footnote 20 referrer

Footnote 21

Joint FAO–OIE–WHO Global Early Warning System. Jan. 20, 2021. SARS-CoV-2 in animals used for fur farming; GLEWS+Risk assessment. https://www.who.int/publications/i/item/WHO-2019-nCoV-fur-farming-risk-assessment-2021.1.

Return to footnote 21 referrer

Footnote 22

de Morais, H. A., A. P. Dos Santos, N. C. do Nascimento, L. B. Kmetiuk, D. S. Barbosa, P. E. Brandão, A. M. S. Guimarães, C. Pettan-Brewer, and A. W. Biondo. 2020. Natural Infection by SARS-CoV-2 in Companion Animals: A Review of Case Reports and Current Evidence of Their Role in the Epidemiology of COVID-19. Front. Vet. Sci. 7:591216.

Return to footnote 22 referrer

Footnote 23

Mishra, A., N. Kumar, S. Bhatia, A. Aasdev, S. Kanniappan, A. T. Sekhar, A. Gopinadhan, R. Silambarasan, C. Sreekumar, C. K. Dubey, M. Tripathi, A. A. Raut, and V. P. Singh. 2021. SARS-CoV-2 Delta Variant among Asiatic Lions, India. Emerg. Infect. Dis. 27:2723-2725.

Return to footnote 23 referrer

Footnote 24

World Organization for Animal Health (OIE). Jan. 26, 2021. 12th Call OIE Ad Hoc Group on COVID-19 at the Animal-Human Interface.

Return to footnote 24 referrer

Footnote 25

Giner, J., S. Villanueva-Saz, A. P. Tobajas, M. D. Pérez, A. González, M. Verde, A. Yzuel, A. García-García, V. Taleb, E. Lira-Navarrete, R. Hurtado-Guerrero, J. Pardo, L. Santiago, J. R. Paño, H. Ruíz, D. Lacasta, and A. Fernández. 2021. SARS-CoV-2 Seroprevalence in Household Domestic Ferrets (Mustela putorius furo). Animals (Basel). 11:667.

Return to footnote 25 referrer

Footnote 26

Middlemiss, C., S. Voas, C. Glossop, and R. Huey. 2021. SARS-CoV-2 in ferrets. Vet. Rec. 188:76-76.

Return to footnote 26 referrer

Footnote 27

Račnik, J., A. Kočevar, B. Slavec, M. Korva, K. R. Rus, S. Zakotnik, T. M. Zorec, M. Poljak, M. Matko, O. Z. Rojs, and T. A. Županc. 2021. Transmission of SARS-CoV-2 from Human to Domestic Ferret. Emerg. Infect. Dis. 27:2450-2453.

Return to footnote 27 referrer

Footnote 28

US Center for Disease Control and Prevention. Dec. 14, 2021. People with Certain Medical Conditions. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.

Return to footnote 28 referrer

Footnote 29

US Center for Disease Control and Prevention. Aug. 2, 2021. COVID-19 Risks and Vaccine Information for Older Adults. https://www.cdc.gov/aging/covid19/covid19-older-adults.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Folder-adults.html.

Return to footnote 29 referrer

Footnote 30

American Veterinary Medical Association. Nov. 15, 2020. SARS-CoV-2 kills thousands of minks in Utah. https://www.avma.org/javma-news/2020-11-15/sars-cov-2-kills-thousands-minks-utah.

Return to footnote 30 referrer

Footnote 31

Koopmans, M. 2021. SARS-CoV-2 and the human-animal interface: outbreaks on mink farms. Lancet Infect. Dis. 21:18-19.

Return to footnote 31 referrer

Footnote 32

Shuai, L., G. Zhong, Q. Yuan, Z. Wen, C. Wang, X. He, R. Liu, J. Wang, Q. Zhao, Y. Liu, N. Huo, J. Deng, J. Bai, H. Wu, Y. Guan, J. Shi, K. Tian, N. Xia, H. Chen, and Z. Bu. 2021. Replication, pathogenicity, and transmission of SARS-CoV-2 in minks. Natl Sci Rev. 8:.

Return to footnote 32 referrer

Footnote 33

US Centers for Disease Control and Prevention. May 7, 2021. Scientific Brief: SARS-CoV-2 Transmission. https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html.

Return to footnote 33 referrer

Footnote 34

US Center for Disease Control and Prevention. Apr. 5, 2021. Science Brief: SARS-CoV-2 and Surface (Fomite) Transmission for Indoor Community Environments. https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html.

Return to footnote 34 referrer

Footnote 35

Sun, J., A. Zhu, H. Li, K. Zheng, Z. Zhuang, Z. Chen, Y. Shi, Z. Zhang, S. B. Chen, X. Liu, J. Dai, X. Li, S. Huang, X. Huang, L. Luo, L. Wen, J. Zhuo, Y. Li, Y. Wang, L. Zhang, Y. Zhang, F. Li, L. Feng, X. Chen, N. Zhong, Z. Yang, J. Huang, J. Zhao, and Y. M. Li. 2020. Isolation of infectious SARS-CoV-2 from urine of a COVID-19 patient. Emerg. Microbes Infect. 9:991-993.

Return to footnote 35 referrer

Footnote 36

Wang, W., Y. Xu, R. Gao, R. Lu, K. Han, G. Wu, and W. Tan. 2020. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA. 323:1843-1844.

Return to footnote 36 referrer

Footnote 37

Lin, G., S. Zhang, Y. Zhong, L. Zhang, S. Ai, K. Li, W. Su, L. Cao, Y. Zhao, F. Tian, J. Li, Y. Wu, C. Guo, R. Peng, X. Wu, P. Gan, W. Zhu, H. Lin, and Z. Zhang. 2021. Community evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission through air. Atmos. Environ. (1994). 246:118083.

Return to footnote 37 referrer

Footnote 38

Kang, M., J. Wei, J. Yuan, J. Guo, Y. Zhang, J. Hang, Y. Qu, H. Qian, Y. Zhuang, X. Chen, X. Peng, T. Shi, J. Wang, J. Wu, T. Song, J. He, Y. Li, and N. Zhong. 2020. Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building. Ann. Intern. Med. 173:974-980.

Return to footnote 38 referrer

Footnote 39

Yuan, J., Z. Chen, C. Gong, H. Liu, B. Li, K. Li, X. Chen, C. Xu, Q. Jing, G. Liu, P. Qin, Y. Liu, Y. Zhong, L. Huang, B. P. Zhu, and Z. Yang. 2020. Sewage as a Possible Transmission Vehicle During a Coronavirus Disease 2019 Outbreak in a Densely populated Community: Guangzhou, China, April 2020. Clin. Infect. Dis.

Return to footnote 39 referrer

Footnote 40

World Health Organization. Feb. 7, 2021. Definition and categorization of the timing of mother-to-child transmission of SARS-CoV-2. https://www.who.int/publications/i/item/WHO-2019-nCoV-mother-to-child-transmission-2021.1.

Return to footnote 40 referrer

Footnote 41

US Centers for Disease Control and Prevention. Feb. 16, 2021. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html.

Return to footnote 41 referrer

Footnote 42

Muñoz-Fontela, C., W. E. Dowling, S. G. P. Funnell, P. S. Gsell, A. X. Riveros-Balta, R. A. Albrecht, H. Andersen, R. S. Baric, M. W. Carroll, M. Cavaleri, C. Qin, I. Crozier, K. Dallmeier, L. de Waal, E. de Wit, L. Delang, E. Dohm, W. P. Duprex, D. Falzarano, C. L. Finch, M. B. Frieman, B. S. Graham, L. E. Gralinski, K. Guilfoyle, B. L. Haagmans, G. A. Hamilton, A. L. Hartman, S. Herfst, S. J. F. Kaptein, W. B. Klimstra, I. Knezevic, P. R. Krause, J. H. Kuhn, R. Le Grand, M. G. Lewis, W. C. Liu, P. Maisonnasse, A. K. McElroy, V. Munster, N. Oreshkova, A. L. Rasmussen, J. Rocha-Pereira, B. Rockx, E. Rodríguez, T. F. Rogers, F. J. Salguero, M. Schotsaert, K. J. Stittelaar, H. J. Thibaut, C. T. Tseng, J. Vergara-Alert, M. Beer, T. Brasel, J. F. W. Chan, A. García-Sastre, J. Neyts, S. Perlman, D. S. Reed, J. A. Richt, C. J. Roy, J. Segalés, S. S. Vasan, A. M. Henao-Restrepo, and D. H. Barouch. 2020. Animal models for COVID-19. Nature. 586:509-515.

Return to footnote 42 referrer

Footnote 43

Cleary, S. J., S. C. Pitchford, R. T. Amison, R. Carrington, C. L. Robaina Cabrera, M. Magnen, M. R. Looney, E. Gray, and C. P. Page. 2020. Animal models of mechanisms of SARS-CoV-2 infection and COVID-19 pathology. Br. J. Pharmacol. 177:4851-4865.

Return to footnote 43 referrer

Footnote 44

Chandler, J. C., Bevins, S. N., Ellis, J. W., Linder, T. J., Tell, R. M., Jenkins-Moore, M., Root, J. J., Lenoch, J. B., Robbe-Austerman, S., DeLiberto, T. J., Gidlewski, T., Kim Torchetti, M., & Shriner, S. A. SARS-CoV-2 exposure in wild white-tailed deer (Odocoileus virginianus). PNAS. e2114828118.

Return to footnote 44 referrer

Footnote 45

World Health Organization. Jan. 29, 2021. Listings of WHO's response to COVID-19. https://www.who.int/news/item/29-06-2020-covidtimeline.

Return to footnote 45 referrer

Footnote 46

World Health Organization. Jan. 23, 2020. Statement on the first meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). https://www.who.int/news/item/23-01-2020-statement-on-the-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).

Return to footnote 46 referrer

Footnote 47

World Health Organization. Dec. 22, 2021. WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/.

Return to footnote 47 referrer

Footnote 48

World Organization for Animal Health (OIE). Oct. 31 2021. SARS-COV-2 in Animals – Situation Report 6.

Return to footnote 48 referrer

Footnote 49

US Department of Agriculture Animal and Plant Health Inspection Service. Dec. 11, 2020. OIE Notification: SARS-CoV-2 Epidemiological Study around Infected Mink Farms Summary.

Return to footnote 49 referrer

Footnote 50

US Department of Agriculture Animal and Plant Health Inspection Service. Aug. 27, 2021. Confirmation of COVID-19 in Deer in Ohio. https://www.aphis.usda.gov/aphis/newsroom/stakeholder-info/sa_by_date/sa-2021/sa-08/covid-deer.

Return to footnote 50 referrer

Footnote 51

World Organization for Animal Health (OIE). Oct. 2021. OIE Technical Factsheet: Infection with SARS-CoV-2 in animals.

Return to footnote 51 referrer

Footnote 52

Government of Canada. Dec. 1, 2021. News Release: First case of SARS-CoV-2 detected in Canadian wildlife. https://www.canada.ca/en/environment-climate-change/news/2021/12/first-case-of-sars-cov-2-detected-in-canadian-wildlife.html.

Return to footnote 52 referrer

Footnote 53

Jia, W., J. Wang, B. Sun, J. Zhou, Y. Shi, and Z. Zhou. 2021. The Mechanisms and Animal Models of SARS-CoV-2 Infection. Front. Cell. Dev. Biol. 9:578825.

Return to footnote 53 referrer

Footnote 54

US Department of Homeland Security. Dec. 7, 2021. Master Question List for COVID-19 (caused by SARS-CoV-2) Monthly Report. https://www.dhs.gov/publication/st-master-question-list-covid-19.

Return to footnote 54 referrer

Footnote 55

Zhang, Z., T. Che, T. Wang, H. Zhao, J. Hong, Q. Su, H. Zhang, S. Zhou, A. Teng, Y. Zhang, Y. Yang, L. Fang, and W. Liu. 2021. Epidemiological features of COVID-19 patients with prolonged incubation period and its implications for controlling the epidemics in China. BMC Public Health. 21:2239.

Return to footnote 55 referrer

Footnote 56

World Health Organization. Apr. 6, 2021. WHO-convened global study of origins of SARS-CoV-2: China Part; Joint WHO-China study: 14 January - 10 February 2021. https://www.who.int/publications/i/item/who-convened-global-study-of-origins-of-sars-cov-2-china-part.

Return to footnote 56 referrer

Footnote 57

Larsen, H. D., J. Fonager, F. K. Lomholt, T. Dalby, G. Benedetti, B. Kristensen, T. R. Urth, M. Rasmussen, R. Lassaunière, T. B. Rasmussen, B. Strandbygaard, L. Lohse, M. Chaine, K. L. Møller, A. N. Berthelsen, S. K. Nørgaard, U. W. Sönksen, A. E. Boklund, A. S. Hammer, G. J. Belsham, T. G. Krause, S. Mortensen, A. Bøtner, A. Fomsgaard, and K. Mølbak. 2021. Preliminary report of an outbreak of SARS-CoV-2 in mink and mink farmers associated with community spread, Denmark, June to November 2020. Euro Surveill. 26:2100009.-7917.ES.2021.26.5.210009.

Return to footnote 57 referrer

Footnote 58

Oude Munnink, B. B., R. S. Sikkema, D. F. Nieuwenhuijse, R. J. Molenaar, E. Munger, R. Molenkamp, A. van der Spek, P. Tolsma, A. Rietveld, M. Brouwer, N. Bouwmeester-Vincken, F. Harders, R. Hakze-van der Honing, M. C. A. Wegdam-Blans, R. J. Bouwstra, C. GeurtsvanKessel, A. A. van der Eijk, F. C. Velkers, L. A. M. Smit, A. Stegeman, W. H. M. van der Poel, and M. P. G. Koopmans. 2021. Transmission of SARS-CoV-2 on mink farms between humans and mink and back to humans. Science. 371:172-177.

Return to footnote 58 referrer

Footnote 59

Government of Canada. Dec. 23, 2021. SARS-CoV-2 variants: National definitions, classifications and public health actions. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/testing-diagnosing-case-reporting/sars-cov-2-variants-national-definitions-classifications-public-health-actions.html.

Return to footnote 59 referrer

Footnote 60

World Health Organization. Dec. 22, 2021. Tracking SARS-CoV-2 variants. https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/.

Return to footnote 60 referrer

Footnote 61

World Health Organization. Jan. 28, 2021. Laboratory biosafety guidance related to coronavirus disease (COVID-19): Interim guidance. https://www.who.int/publications/i/item/WHO-WPE-GIH-2021.1.

Return to footnote 61 referrer

Footnote 62

Patterson, E. I., T. Prince, E. R. Anderson, A. Casas-Sanchez, S. L. Smith, C. Cansado-Utrilla, T. Solomon, M. J. Griffiths, Á Acosta-Serrano, L. Turtle, and G. L. Hughes. 2020. Methods of Inactivation of SARS-CoV-2 for Downstream Biological Assays. J. Infect. Dis. 222:1462-1467.

Return to footnote 62 referrer

Footnote 63

Kwok, C. S., M. Dashti, J. Tafuro, M. Nasiri, E. A. Muntean, N. Wong, T. Kemp, G. Hills, and C. D. Mallen. 2021. Methods to disinfect and decontaminate SARS-CoV-2: a systematic review of in vitro studies. Ther. Adv. Infect. Dis. 8:2049936121998548.

Return to footnote 63 referrer

Footnote 64

Chan, K. H., S. Sridhar, R. R. Zhang, H. Chu, A. Y. Fung, G. Chan, J. F. Chan, K. K. To, I. F. Hung, V. C. Cheng, and K. Y. Yuen. 2020. Factors affecting stability and infectivity of SARS-CoV-2. J. Hosp. Infect. 106:226-231.

Return to footnote 64 referrer

Footnote 65

Biasin, M., A. Bianco, G. Pareschi, A. Cavalleri, C. Cavatorta, C. Fenizia, P. Galli, L. Lessio, M. Lualdi, E. Tombetti, A. Ambrosi, E. M. A. Redaelli, I. Saulle, D. Trabattoni, A. Zanutta, and M. Clerici. 2021. UV-C irradiation is highly effective in inactivating SARS-CoV-2 replication. Sci. Rep. 11:6260-021-85425-w.

Return to footnote 65 referrer

Footnote 66

Chen, Z., G. Garcia Jr, V. Arumugaswami, and R. E. Wirz. 2020. Cold atmospheric plasma for SARS-CoV-2 inactivation. Phys. Fluids (1994). 32:111702.

Return to footnote 66 referrer

Footnote 67

Bayarri, B., A. Cruz-Alcalde, N. López-Vinent, M. M. Micó, and C. Sans. 2021. Can ozone inactivate SARS-CoV-2? A review of mechanisms and performance on viruses. J. Hazard. Mater. 415:125658.

Return to footnote 67 referrer

Footnote 68

Inagaki, H., A. Saito, H. Sugiyama, T. Okabayashi, and S. Fujimoto. 2020. Rapid inactivation of SARS-CoV-2 with deep-UV LED irradiation. Emerg. Microbes Infect. 9:1744-1747.

Return to footnote 68 referrer

Footnote 69

Leung, A., K. Tran, J. Audet, S. Lavineway, N. Bastien, and J. Krishnan. 2020. In Vitro Inactivation of SARS-CoV-2 Using Gamma Radiation. Appl. Biosafety. 25:157-160.

Return to footnote 69 referrer

Footnote 70

Sloan, A., T. Cutts, B. D. Griffin, S. Kasloff, Z. Schiffman, M. Chan, J. Audet, A. Leung, D. Kobasa, D. R. Stein, D. Safronetz, and G. Poliquin. 2021. Simulated sunlight decreases the viability of SARS-CoV-2 in mucus. PLoS One. 16:e0253068.

Return to footnote 70 referrer

Footnote 71

Simmons, S. E., R. Carrion, K. J. Alfson, H. M. Staples, C. Jinadatha, W. R. Jarvis, P. Sampathkumar, R. F. Chemaly, F. Khawaja, M. Povroznik, S. Jackson, K. S. Kaye, R. M. Rodriguez, and M. A. Stibich. 2021. Deactivation of SARS-CoV-2 with pulsed-xenon ultraviolet light: Implications for environmental COVID-19 control. Infect. Control Hosp. Epidemiol. 42:127-130.

Return to footnote 71 referrer

Footnote 72

Ratnesar-Shumate, S., G. Williams, B. Green, M. Krause, B. Holland, S. Wood, J. Bohannon, J. Boydston, D. Freeburger, I. Hooper, K. Beck, J. Yeager, L. A. Altamura, J. Biryukov, J. Yolitz, M. Schuit, V. Wahl, M. Hevey, and P. Dabisch. 2020. Simulated Sunlight Rapidly Inactivates SARS-CoV-2 on Surfaces. J. Infect. Dis. 222:214-222.

Return to footnote 72 referrer

Footnote 73

Liu, Y., T. Li, Y. Deng, S. Liu, D. Zhang, H. Li, X. Wang, L. Jia, J. Han, Z. Bei, L. Li, and J. Li. 2021. Stability of SARS-CoV-2 on environmental surfaces and in human excreta. J. Hosp. Infect. 107:105-107.

Return to footnote 73 referrer

Footnote 74

Marzoli, F., A. Bortolami, A. Pezzuto, E. Mazzetto, R. Piro, C. Terregino, F. Bonfante, and S. Belluco. 2021. A systematic review of human coronaviruses survival on environmental surfaces. Sci. Total Environ. 778:146191.

Return to footnote 74 referrer

Footnote 75

Kwon, T., N. N. Gaudreault, and J. A. Richt. 2021. Seasonal Stability of SARS-CoV-2 in Biological Fluids. Pathogens. 10:540.

Return to footnote 75 referrer

Footnote 76

van Doremalen, N., T. Bushmaker, D. H. Morris, M. G. Holbrook, A. Gamble, B. N. Williamson, A. Tamin, J. L. Harcourt, N. J. Thornburg, S. I. Gerber, J. O. Lloyd-Smith, E. de Wit, and V. J. Munster. 2020. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N. Engl. J. Med. 382:1564-1567.

Return to footnote 76 referrer

Footnote 77

Kevadiya, B. D., J. Machhi, J. Herskovitz, M. D. Oleynikov, W. R. Blomberg, N. Bajwa, D. Soni, S. Das, M. Hasan, M. Patel, A. M. Senan, S. Gorantla, J. McMillan, B. Edagwa, R. Eisenberg, C. B. Gurumurthy, S. P. M. Reid, C. Punyadeera, L. Chang, and H. E. Gendelman. 2021. Diagnostics for SARS-CoV-2 infections. Nat. Mater. 20:593-605.

Return to footnote 77 referrer

Footnote 78

Public Health Agency of Canada. Aug. 17, 2020. Clinical Management of Patients with COVID-19 – 2nd Interim Guidance. https://canadiancriticalcare.org/resources/Documents/AMMI-CCCS-PHAC-clinical-guidance-Aug21-EN-FINAL.pdf.

Return to footnote 78 referrer

Footnote 79

American Veterinary Medical Association. Mar. 2, 2021. Caring for your pet with SARS-CoV-2. https://ebusiness.avma.org/files/coronavirus/AVMA_SARS-CoV-2_Caring-for-pets_Client-handout.pdf.

Return to footnote 79 referrer

Footnote 80

World Organization for Animal Health (OIE). Jun. 1, 2021. Guidance on working with farmed animals of species susceptible to infection with SARS-CoV-2.

Return to footnote 80 referrer

Footnote 81

Aleccia, J. Dec. 23, 2020. At risk of extinction, black-footed ferrets get experimental COVID vaccine. Global Biodefense. https://globalbiodefense.com/2020/12/23/at-risk-of-extinction-black-footed-ferrets-get-experimental-covid-vaccine/.

Return to footnote 81 referrer

Footnote 82

Chavda, V. P., J. Feehan, and V. Apostolopoulos. 2021. A Veterinary Vaccine for SARS-CoV-2: The First COVID-19 Vaccine for Animals. Vaccines (Basel). 9:631.

Return to footnote 82 referrer

Footnote 83

Daly, N. Aug. 20, 2021. Bears, baboons, tigers are getting COVID vaccines at zoos across the US. Nat Geo. https://www.nationalgeographic.com/animals/article/bears-baboons-tigers-are-getting-covid-vaccines-at-zoos-across-the-us.

Return to footnote 83 referrer

Footnote 84

Finnish Fur Breeders' Association (FIFUR). Dec. 22, 2021. Press Release: Corona vaccinations on mink started on the first farms in Finland and the EU. https://www.epressi.com/media/userfiles/139915/1640097837/fifur_press-release-corona-vaccination-on-mink-starts-2021_20211222_en.pdf.

Return to footnote 84 referrer

Footnote 85

UAE Department of Health. Dec. 20, 2021. Abu Dhabi Receives the First Global Shipment of the New AstraZeneca "Evusheld" COVID-19 Medication. https://www.doh.gov.ae/en/news/Abu-Dhabi-Receives-the-First-Global-Shipment-of-the-New-AstraZeneca-Evusheld-COVID-19-Medication.

Return to footnote 85 referrer

Footnote 86

US FDA. Dec. 8, 2021. Coronavirus (COVID-19) Update: FDA Authorizes New Long-Acting Monoclonal Antibodies for Pre-exposure Prevention of COVID-19 in Certain Individuals. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-new-long-acting-monoclonal-antibodies-pre-exposure.

Return to footnote 86 referrer

Footnote 87

Parmegiani, L., and G. Vajta. 2021. COVID-19 in liquid nitrogen: a potential danger still disregarded. Hum. Reprod. 36:260.

Return to footnote 87 referrer

Footnote 88

Scarica, C., L. Parmegiani, L. Rienzi, A. Anastasi, D. Cimadomo, F. G. Klinger, E. Licata, L. Sosa Fernandez, and L. De Santis. 2021. SARS-CoV-2 persistence at subzero temperatures. J. Assist. Reprod. Genet. 38:779-781.

Return to footnote 88 referrer

Footnote 89

Gabbrielli, M., C. Gandolfo, G. Anichini, T. Candelori, M. Benvenuti, G. G. Savellini, and M. G. Cusi. 2021. How long can SARS-CoV-2 persist in human corpses? Int. J. Infect. Dis. 106 : 1-2.

Return to footnote 89 referrer

Page details

Date modified:: 2023-04-13