Challenges and future opportunities to unlock the critical supply chain of personal and protective equipment (PPE) encompassing decontamination and reuse under emergency use authorization (EUA) conditions during the COVID-19 pandemic: Through a reflective circularity and sustainability lens.

Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), and the resulting coronavirus disease (COVID-19), was declared a public health emergency of global concern by the World Health Organization (WHO) in the early months of 2020. There was a marked lack of knowledge to inform national pandemic response plans encompassing appropriate disease mitigation and preparation strategies to constrain and manage COVID-19. For example, the top 16 "most cited" papers published at the start of the pandemic on core knowledge gaps collectively constitute a staggering 29,393 citations. Albeit complex, appropriate decontamination modalities have been reported and developed for safe reuse of personal and protective equipment (PPE) under emergency use authorization (EUA) where critical supply chain shortages occur for healthcare workers (HCWs) caused by the COVID-19 pandemic. Commensurately, these similar methods may provide solutions for the safe decontamination of enormous volumes of PPE waste promoting opportunities in the circular bioeconomy that will also protect our environment, habitats and natural capital. The co-circulation of the highly transmissive mix of COVID-19 variants of concern (VoC) will continue to challenge our embattled healthcare systems globally for many years to come with an emphasis placed on maintaining effective disease mitigation strategies. This viewpoint article addresses the rationale and key developments in this important area since the onset of the COVID-19 pandemic and provides an insight into a variety of potential opportunities to unlock the long-term sustainability of single-use medical devices, including waste management.

Effectiveness of front line and emerging fungal disease prevention and control interventions and opportunities to address appropriate eco-sustainable solutions.

Fungal pathogens contribute to significant disease burden globally; however, the fact that fungi are eukaryotes has greatly complicated their role in fungal-mediated infections and alleviation. Antifungal drugs are often toxic to host cells and there is increasing evidence of adaptive resistance in animals and humans. Existing fungal diagnostic and treatment regimens have limitations that has contributed to the alarming high mortality rates and prolonged morbidity seen in immunocompromised cohorts caused by opportunistic invasive infections as evidenced during HIV and COVID-19 pandemics. There is a need to develop real-time monitoring and diagnostic methods for fungal pathogens and to create a greater awareness as to the contribution of fungal pathogens in disease causation. Greater information is required on the appropriate selection and dose of antifungal drugs including factors governing resistance where there is commensurate need to discover more appropriate and effective solutions. Popular azole fungal drugs are widely detected in surface water and sediment due to incomplete removal in wastewater treatment plants where they are resistant to microbial degradation and may cause toxic effects on aquatic organisms such as algae and fish. UV has limited effectiveness in destruction of anti-fungal drugs where there is increased interest in the combination approaches such as novel use of pulsed-plasma gas-discharge technologies for environmental waste management. There is growing interest in developing alternative and complementary green eco-biocides and disinfection innovation. Fungi present challenges for cleaning, disinfection and sterilization of reusable medical devices such as endoscopes where they (example, Aspergillus and Candida species) can be protected when harboured in build-up biofilm from lethal processing. Information on the efficacy of established disinfection and sterilization technologies to address fungal pathogens including bottleneck areas that present high risk to patients is lacking. There is a need to address risk mitigation and modelling to inform efficacy of appropriate intervention technologies that must consider all contributing factors where there is potential to adopt digital technologies to enable real-time analysis of big data, such as use of artificial intelligence and machine learning. International consensus on standardised protocols for developing and reporting on appropriate alternative eco-solutions must be reached, particularly in order to address fungi with increasing drug resistance where research and innovation can be enabled using a One Health approach.

Efficacy of frontline chemical biocides and disinfection approaches for inactivating SARS-CoV-2 variants of concern that cause coronavirus disease with the emergence of opportunities for green eco-solutions.

The emergence of severe acute respiratory disease (SARS-CoV-2) variants that cause coronavirus disease is of global concern. Severe acute respiratory disease variants of concern (VOC) exhibiting greater transmissibility, and potentially increased risk of hospitalization, severity and mortality, are attributed to molecular mutations in outer viral surface spike proteins. Thus, there is a reliance on using appropriate counter-disease measures, including non-pharmaceutical interventions and vaccination. The best evidence suggests that the use of frontline biocides effectively inactivate coronavirus similarly, including VOC, such as 202012/01, 501Y.V2 and P.1 that have rapidly replaced the wild-type variant in the United Kingdom, South Africa and Brazil, respectively. However, this review highlights that efficacy of VOC-disinfection will depend on the type of biocide and the parameters governing the activity. VOC are likely to be similar in size to the wild-type strain, thus implying that existing guidelines for use and re-use of face masks post disinfection remain relevant. Monitoring to avoid injudicious use of biocides during the coronavirus disease era is required as prolonged and excessive biocide usage may negatively impact our receiving environments; thus, highlighting the potential for alternative more environmental-friendly sustainable biocide solutions. Traditional biocides may promote cross-antimicrobial resistance to antibiotics in problematical bacteria. The existing filtration efficacy of face masks is likely to perform similarly for VOC due to similar viral size; however, advances in face mask manufacturing by way incorporating new anti-viral materials will potentially enhance their design and functionality for existing and potential future pandemics.

Empower Eco Multi-Actor HUB: a triple helix “academia-industry-authority” approach to creating and sharing potentially disruptive tools for addressing novel and emerging new Green Deal opportunities under a United Nations’ Sustainable Development Goals framework

There is a pressing drive to address climate change and environmental degradation that are global existential threats. Europe has strategically responded by unifying efforts to transform its’ connected communities into a modern, resource-efficient and competitive economy with a trajectory to enable no net greenhouse gas emissions by 2050;thus, ensuring economic growth is decoupled from resource utilisation, and that no person or place is left behind. The European Green Deal is an ambitious plan to make the European economy sustainable;however, there is no reference blue-print for the safe and just transitioning to low carbon economy. This constitutes first description of a triple helix (academic-industry-authority) concept underpinning operation of multi-actor innovation hub that can be strategically applied to enable this transition that develops green innovation and enterprises. Innovative tools for meeting the United Nations’ Sustainable Development Goals are informed by appropriate technology, policy and society readiness levels from idea to final market/wider society deployment. “Empower-Eco Sustainability HUB”, is a digitised “living lab” established in the Irish peatlands that converges academia, communities, social enterprises, industries, policy and decision makers.. It develops green innovation in intended environments at demo/test-beds, such as for digital, agri-food, bioeconomy and bio-based sectors, and embraces climate proofing and COVID-19 recovery.

Innovations and technology disruptions in the food sector within the COVID-19 pandemic and post-lockdown era.

Background: COVID-19 pandemic has caused a global lockdown that has abruptly shut down core businesses and caused a worldwide recession. The forecast for a smooth transition for the agri-food and drink industry is, at best, alarming. Given that COVID-19 shutdown multiple core services (such as aviation, food services, supply chains, and export and import markets), there is an enormous deficiency in critical information to inform priority decision making for companies where this uncertainly is likely to impact negatively upon recovery. Scope and approach: The current article investigates potential innovations within the era of the COVID-19 crisis after framing them within the four issues of the food sector (food safety, bioactive food compounds, food security, and sustainability) that are directly affected by the pandemic. The prospect of foreseen innovations to disrupt the food sector during lockdown periods and the post-COVID-19 era is also discussed. Key findings and conclusions: Internet and Communication Technologies, blockchain in the food supply chain and other Industry 4.0 applications, as well as approaches that redefine the way we consume food (e.g., lab-grown meat, plant-based alternatives of meat, and valorization of a vast range of bioresources), are the innovations with the highest potential in the new era. There is also an equally pressing need to exploit social marketing to understand attitudes, perceptions, and barriers that influence the behavior change of consumers and the agri-food industry. Subsequently, this change will contribute to adapting to new norms forged by the COVID-19 pandemic, where there is a significant gap in knowledge for decision making.

Disposable face masks and reusable face coverings as non-pharmaceutical interventions (NPIs) to prevent transmission of SARS-CoV-2 variants that cause coronavirus disease (COVID-19): Role of new sustainable NPI design innovations and predictive mathematical modelling.

Best-published evidence supports the combined use of vaccines with non-pharmaceutical interventions (NPIs), to reduce the relative risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19; this will enable a safe transition to achieving herd immunity. Albeit complex, the strategic public health goal is to bundle NPIs to keep the basic reproduction number R0 below one. However, validation of these NPIs is conducted using random clinical trials, which is challenging in a swiftly moving pandemic given the need for recruiting large participant cohort over a longitudinal analysis period. This review highlights emerging innovations for potentially improving the design, functionality and improved waste management of disposable face masks such as filtering facepiece (FFPs) respirators, medical masks, and reusable face coverings to help prevent COVID-19. It describes use of different mathematical models under varying scenarios to inform efficacy of single and combined use of NPIs as important counter-measures to break the cycle of COVID-19 infection including new SARS-CoV-2 variants. Demand for face masks during COVID-19 pandemic keeps increasing, especially for FFPs worn by medical workers. Collaborative and well-conducted randomised controlled trials across borders are required to generate robust data to inform common and consistent policies for COVID-19 and future pandemic planning and management; however, current use of systematic reviews of best available evidence can be considered to guide interim policies.

Food Ingredients and Active Compounds against the Coronavirus Disease (COVID-19) Pandemic: A Comprehensive Review.

As media reports have noted, the COVID-19 pandemic has accelerated market mainstreaming of immune-boosting food bioactives, supplements, and nutraceuticals. However, most studies reporting on the potential of bioactives against COVID-19 transmission have been uploaded as preprints with little opportunity to revise content for benefit and impact. The current review discusses current best evidence and information underpinning the role of food ingredients and bioactive compounds in supporting immune functions in humans and animals, specifically in the prevention and treatment of COVID-19 disease. Up to now, some evidence from randomized population and clinical trials has suggested that vitamin D levels may be linked to COVID-19 transmission and severity. Numerous theoretical studies have pointed to polyphenols and particularly flavonoids as potential inhibitors of SARS-CoV-2 infection. There is also inconclusive evidence to support the future use of ß-glucan to address COVID-19 due in part to variability in immune response arising from heterogeneity in polysaccharide branch and chain length for different sources and the absence of a standardized extraction method. To confirm the promising outcomes and hypotheses for bioactive compounds, more randomized and controlled clinical studies are needed. The results of such studies would have a profound effect on the prospects of food supplements and nutraceuticals as potential prophylaxis against COVID-19 and serve to help consumers to protect themselves during the post-lockdown recovery era.

Unlocking the surge in demand for personal and protective equipment (PPE) and improvised face coverings arising from coronavirus disease (COVID-19) pandemic - Implications for efficacy, re-use and sustainable waste management.

Currently, there is no effective vaccine for tackling the ongoing COVID-19 pandemic caused by SARS-CoV-2 with the occurrence of repeat waves of infection frequently stretching hospital resources beyond capacity. Disease countermeasures rely upon preventing person-to-person transmission of SARS-CoV2 so as to protect front-line healthcare workers (HCWs). COVID-19 brings enormous challenges in terms of sustaining the supply chain for single-use-plastic personal and protective equipment (PPE). Post-COVID-19, the changes in medical practice will drive high demand for PPE. Important countermeasures for preventing COVID-19 transmission include mitigating potential high risk aerosol transmission in healthcare setting using medical PPE (such as filtering facepiece respirators (FFRs)) and the appropriate use of face coverings by the general public that carries a lower transmission risk. PPE reuse is a potential short term solution during COVID-19 pandemic where there is increased evidence for effective deployment of reprocessing methods such as vaporized hydrogen peroxide (30 to 35% VH2O2) used alone or combined with ozone, ultraviolet light at 254 nm (2000 mJ/cm2) and moist heat (60 °C at high humidity for 60 min). Barriers to PPE reuse include potentially trust and acceptance by HCWs. Efficacy of face coverings are influenced by the appropriate wearing to cover the nose and mouth, type of material used, number of layers, duration of wearing, and potentially superior use of ties over ear loops. Insertion of a nose clip into cloth coverings may help with maintaining fit. Use of 60 °C for 60 min (such as, use of domestic washing machine and spin dryer) has been advocated for face covering decontamination. Risk of virus infiltration in improvised face coverings is potentially increased by duration of wearing due to humidity, liquid diffusion and virus retention. Future sustained use of PPE will be influenced by the availability of recyclable PPE and by innovative biomedical waste management.

Unlocking challenges and opportunities presented by COVID-19 pandemic for cross-cutting disruption in agri-food and green deal innovations: Quo Vadis?

COVID-19 pandemic is on a trajectory to cause catastrophic global upheaval with the potential to alter geopolitical and socio-economic norms. Many countries are frantically responding with staggering financial stimulus recovery initiatives. This opinion-paper reviews challenges, opportunities, and potential solutions for the post-COVID-19 era that focuses on intensive sustaining of agri-food supply chain in tandem with meeting the high demand for new green deal innovation. For example, the development of wet peatland innovation, known as Paludiculture, can intensively sustain and blend agri-food and green innovations that will help support COVID-19 pandemic transitioning. The future looks bright for the creation of new sustainability multi-actor innovation hubs that will support, connect, and enable businesses to recover and pivot beyond the COVID-19 pandemic. The nexus between first 'Green Deal' initiative supporting 64 selected European Startups and SMEs (European Innovation Council) and 43 Irish Disruptive Technology projects are addressed in the context of cross-cutting developments and relevance to COVID-19. Candidate areas for future consideration will focus on climate action, digitization, manufacturing, and sustainable food production, security, and waste mitigation. Recommendations are also provided to facilitate community transitioning, training, enterprise, and employment to low carbon economy.

beta-Glucan extracts from the same edible shiitake mushroom Lentinus edodes produce differential in-vitro immunomodulatory and pulmonary cytoprotective effects - Implications for coronavirus disease (COVID-19) immunotherapies

Coronavirus pneumonia is accompanied by rapid virus replication, where a large number of inflammatory cell infiltration and cytokine storm may lead to acute lung injury, acute respiratory distress syndrome (ARDS) and death. The uncontrolled release of pro-inflammatory cytokines, including interleukin (IL)-1beta and IL-6, is associated with ARDS. This constituted the first study to report on the variability in physicochemical properties of beta-glucans extracts from the same edible mushroom Lentinus edodes on the reduction of these pro-inflammatory cytokines and oxidative stress. Specifically, the impact on the immunomodulatory and cytoprotective properties of our novel in 'house' (IH-Lentinan, IHL) and a commercial (Carbosynth-Lentinan, CL) Lentinan extract were investigated using in vitro models of lung injury and macrophage phagocytosis. CL comprised higher amounts of alpha-glucans and correspondingly less beta-glucans. The two lentinan extracts demonstrated varying immunomodulatory activities. Both Lentinan extracts reduced cytokine-induced NF-kappaB activation in human alveolar epithelial A549 cells, with the IHL extract proving more effective at lower doses. In contrast, in activated THP-1 derived macrophages, the CL extract more effectively attenuated pro-inflammatory cytokine production (TNF-alpha, IL-8, IL-2, IL-6, IL-22) as well as TGF-beta and IL-10. The CL extract attenuated oxidative stress-induced early apoptosis, while the IHL extract attenuated late apoptosis. Our findings demonstrate significant physicochemical differences between Lentinan extracts, which produce differential in vitro immunomodulatory and pulmonary cytoprotective effects that may also have positive relevance to candidate COVID-19 therapeutics targeting cytokine storm.

Challenges and solutions for addressing critical shortage of supply chain for personal and protective equipment (PPE) arising from Coronavirus disease (COVID19) pandemic - Case study from the Republic of Ireland.

Coronavirus (COVID-19) is highly infectious agent that causes fatal respiratory illnesses, which is of great global public health concern. Currently, there is no effective vaccine for tackling this COVID19 pandemic where disease countermeasures rely upon preventing or slowing person-to-person transmission. Specifically, there is increasing efforts to prevent or reduce transmission to front-line healthcare workers (HCW). However, there is growing international concern regarding the shortage in supply chain of critical one-time-use personal and protective equipment (PPE). PPE are heat sensitive and are not, by their manufacturer's design, intended for reprocessing. Most conventional sterilization technologies used in hospitals, or in terminal medical device sterilization providers, cannot effectively reprocess PPE due to the nature and severity of sterilization modalities. Contingency planning for PPE stock shortage is important. Solutions in the Republic of Ireland include use of smart communication channels to improve supply chain, bespoke production of PPE to meets gaps, along with least preferred option, use of sterilization or high-level disinfection for PPE reprocessing. Reprocessing PPE must consider material composition, functionality post treatment, along with appropriate disinfection. Following original manufacturer of PPE and regulatory guidance is important. Technologies deployed in the US, and for deployment in the Republic of Ireland, are eco-friendly, namely vaporised hydrogen peroxide (VH2O2), such as for filtering facepiece respirators and UV irradiation and High-level liquid disinfection (Actichlor+) is also been pursed in Ireland. Safeguarding supply chain of PPE will sustain vital healthcare provision and will help reduce mortality.