Summary Background Since the coronavirus disease 2019 outbreak began in the Chinese city of Wuhan on Dec 31, 2019, 68 imported cases and 175 locally acquired infections have been reported in Singapore. We aimed to investigate options for early intervention in Singapore should local containment (eg, preventing disease spread through contact tracing efforts) be unsuccessful. Methods We adapted an influenza epidemic simulation model to estimate the likelihood of human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a simulated Singaporean population. Using this model, we estimated the cumulative number of SARS-CoV-2 infections at 80 days, after detection of 100 cases of community transmission, under three infectivity scenarios (basic reproduction number [R0] of 1·5, 2·0, or 2·5) and assuming 7·5% of infections are asymptomatic. We first ran the model assuming no intervention was in place (baseline scenario), and then assessed the effect of four intervention scenarios compared with a baseline scenario on the size and progression of the outbreak for each R0 value. These scenarios included isolation measures for infected individuals and quarantining of family members (hereafter referred to as quarantine); quarantine plus school closure; quarantine plus workplace distancing; and quarantine, school closure, and workplace distancing (hereafter referred to as the combined intervention). We also did sensitivity analyses by altering the asymptomatic fraction of infections (22·7%, 30·0%, 40·0%, and 50·0%) to compare outbreak sizes under the same control measures. Findings For the baseline scenario, when R0 was 1·5, the median cumulative number of infections at day 80 was 279 000 (IQR 245 000–320 000), corresponding to 7·4% (IQR 6·5–8·5) of the resident population of Singapore. The median number of infections increased with higher infectivity: 727 000 cases (670 000–776 000) when R0 was 2·0, corresponding to 19·3% (17·8–20·6) of the Singaporean population, and 1 207 000 cases (1 164 000–1 249 000) when R0 was 2·5, corresponding to 32% (30·9–33·1) of the Singaporean population. Compared with the baseline scenario, the combined intervention was the most effective, reducing the estimated median number of infections by 99·3% (IQR 92·6–99·9) when R0 was 1·5, by 93·0% (81·5–99·7) when R0 was 2·0, and by 78·2% (59·0 −94·4) when R0 was 2·5. Assuming increasing asymptomatic fractions up to 50·0%, up to 277 000 infections were estimated to occur at day 80 with the combined intervention relative to 1800 for the baseline at R0 of 1·5. Interpretation Implementing the combined intervention of quarantining infected individuals and their family members, workplace distancing, and school closure once community transmission has been detected could substantially reduce the number of SARS-CoV-2 infections. We therefore recommend immediate deployment of this strategy if local secondary transmission is confirmed within Singapore. However, quarantine and workplace distancing should be prioritised over school closure because at this early stage, symptomatic children have higher withdrawal rates from school than do symptomatic adults from work. At higher asymptomatic proportions, intervention effectiveness might be substantially reduced requiring the need for effective case management and treatments, and preventive measures such as vaccines. Funding Singapore Ministry of Health, Singapore Population Health Improvement Centre.

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

The water-energy-food nexus and COVID-19: Towards a systematization of impacts and responses.

Agri-food systems (AFS) have been central in the debate on sustainable development. Despite this growing interest in AFS, comprehensive analyses of the scholarly literature are hard to find. Therefore, the present systematic review delineated the contours of this growing research strand and analyzed how it relates to sustainability. A search performed on the Web of Science in January 2020 yielded 1389 documents, and 1289 were selected and underwent bibliometric and topical analyses. The topical analysis was informed by the SAFA (Sustainability Assessment of Food and Agriculture systems) approach of FAO and structured along four dimensions viz. environment, economy, society and culture, and policy and governance. The review shows an increasing interest in AFS with an exponential increase in publications number. However, the study field is north-biased and dominated by researchers and organizations from developed countries. Moreover, the analysis suggests that while environmental aspects are sufficiently addressed, social, economic, and political ones are generally overlooked. The paper ends by providing directions for future research and listing some topics to be integrated into a comprehensive, multidisciplinary agenda addressing the multifaceted (un)sustainability of AFS. It makes the case for adopting a holistic, 4-P (planet, people, profit, policy) approach in agri-food system studies.

Sustainable Agri-Food Systems: Environment, Economy, Society, and Policy

According to United Nations, World Tourism Organization COVID-19 has had the most devastating impact on the entire global tourism value chain, which resulted in a 74% decline in international passenger arrival, a US$1.3 trillion loss in international tourism receipts, over the US $ 2trillion loss of global domestic product and placing between 100 and 120 million jobs at risk globally. While the initial impact of the pandemic was uniform across the world, the recovery was expected to be varied across the region due to inequitable access to the COVID-19 vaccine. This study seeks to examine the implications of vaccination inequity on tourism recovery in the global tourism market. The study uses secondary, archival data and harnesses the advantages of big data generated from online activities from tourists and tourism companies obtained from authoritative sources. The study found that inequitable access to vaccinations produced a skewed recovery favouring vaccinated regions concentrated in the developed world, leaving poor regions such as Africa behind. The robot system characterising the vaccine-induced recovery had also created a vaccine diplomatic nightmare that scuttled global tourism recovery efforts. To ensure sustainable recovery, there is a need to ensure global vaccination access by rechannelling some of the excess vaccines in developed countries to countries that needs them to ensure the opening up of the entire tourism global market and reduce vulnerabilities that are coming from COVID-19 variants, which poses a threat to the gains made from the current vaccination program. The study concludes that there will not be any meaningful economic recovery without a wholesale approach covering the entire global population. 

COVID-19 vaccine-induced recovery and the implications of vaccine apartheid on the global tourism industry

The coronavirus disease 2019 (COVID-19) pandemic has had significant morbidity, mortality, social and financial implications for the global population. Despite this knowledge, we still know very little about how COVID-19 infection affects quality of life resulting from changes in nutritional behaviour and, conversely, how nutrition could modulate the epidemiology of COVID-19. In addition, the social isolation most have experienced due to the regulations imposed by governments during the COVID-19 pandemic may have also had effects on our nutritional behaviour. It is possible that nutritional interventions may have effects on the incidence of COVID-19 infection and mortality rates. The purpose of this review is to evaluate the current status of research on the topic of nutrition as it relates to the COVID-19 pandemic.

The Impact of Nutrition on the COVID-19 Pandemic and the Impact of the COVID-19 Pandemic on Nutrition

We present scientific perspectives on the impact of the COVID-19 pandemic and global food security. International organizations and current evidence based on other respiratory viruses suggests COVID-19 is not a food safety issue, i.e., there is no evidence associating food or food packaging with the transmission of the virus causing COVID-19 (SARS-CoV-2), yet an abundance of precaution for this exposure route seems appropriate. The pandemic, however, has had a dramatic impact on the food system, with direct and indirect consequences on lives and livelihoods of people, plants, and animals. Given the complexity of the system at risk, it is likely that some of these consequences are still to emerge over time. To date, the direct and indirect consequences of the pandemic have been substantial including restrictions on agricultural workers, planting, current and future harvests; shifts in agricultural livelihoods and food availability; food safety; plant and animal health and animal welfare; human nutrition and health; along with changes in public policies. All aspects are crucial to food security that would require "One Health" approaches as the concept may be able to manage risks in a cost-effective way with cross-sectoral, coordinated investments in human, environmental, and animal health. Like climate change, the effects of the COVID-19 pandemic will be most acutely felt by the poorest and most vulnerable countries and communities. Ultimately, to prepare for future outbreaks or threats to food systems, we must take into account the Sustainable Development Goals of the United Nations and a "Planetary Health" perspective.

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Andrea I Moreno-Switt

Papers

The COVID-19 Pandemic and Global Food Security.