This is the first comprehensive text to provide not only a detailed explanation of how the SARS-CoV2 (COVID-19) virus is spread within human populations, but also an epidemiological analysis and interpretation of viral pandemics to enable better measures for prevention and control. Providing an introduction to the physiology of both the human immune system and the SARS-CoV2 virus, specifically the virus’s replicative potential and our own vulnerability, the book offers an in-depth understanding of how the pandemic evolved. It also highlights the aberrant epigenomic mechanistic process in pathogenic microbe’s replication and survival, implying gene and environment interaction that affected different populations. Citing a range of environmental conditions, from structural and systemic racism to malnutrition and low-socioeconomic status, the book examines how these factors exacerbated existing health disparities, resulting in a disproportionate burden of morbidity and mortality on certain social groups. Also providing invaluable guidance on how future iterations of this pandemic may be better prevented and controlled, this will be a defining book for students, researchers and professionals within Public Health and Clinical Medicine to better understand the SARS-CoV2 (COVID-19) virus, and how to protect the most vulnerable social groups.

The COVID-19 pandemic has disproportionately affected those population sectors that experience inequality. Specifically, marginalized racial and ethnic populations with pre-existing health conditions, those living in poverty, those possessing a low education level, hourly wage employees, etc. have experienced an excess burden of COVID-19 morbidity and mortality compared to their White counterparts in developed countries. The interaction of the social determinants of health with a novel virus has made visible the inequities that have been hidden or accustomed to in many communities globally. As we work to end the current pandemic, we must consider the post-COVID-19 pandemic era and address the social determinants of health so that populations start from a place of health, as opposed to a place of disease for the next public health challenge. Syndemic research has demonstrated the interaction among socio-cultural factors, socio-economic factors, structural factors, and individual factors (collectively referred to as the social determinants of health) and infectious disease epidemics (e.g., COVID-19, AIDS) and social epidemics (e.g., structural racism). These interactions can exacerbate and sustain adverse health outcomes for marginalized populations. How can communities improve the social determinants of health for impoverished populations? The importance of doing so would have implications not only for the health status of communities but could also improve economic conditions for these geographic areas. Addressing the social determinants of health for marginalized populations has the potential to improve health for all.

Volume I.A An outbreak of a respiratory disease first reported in Wuhan, China in December 2019 and the causative agent was discovered in January 2020 to be a novel betacoronovirus of the same subgenus as SARS-CoV and named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19) has rapidly disseminated worldwide, with clinical manifestations ranging from mild respiratory symptoms to severe pneumonia and a fatality rate estimated around 2%. Person to person transmission is occurring both in the community and healthcare settings. The World Health Organization (WHO) has recently declared the COVID-19 epidemic a public health emergency of international concern. The ongoing outbreak presents many clinical and public health management challenges due to limited understanding of viral pathogenesis, risk factors for infection, natural history of disease including clinical presentation and outcomes, prognostic factors for severe illness, period of infectivity, modes and extent of virus inter-human transmission, as well as effective preventive measures and public health response and containment interventions. There are no antiviral treatment nor vaccine available but fast track research and development efforts including clinical therapeutic trials are ongoing across the world. Managing this serious epidemic requires the appropriate deployment of limited human resources across all cadres of health care and public health staff, including clinical, laboratory, managerial and epidemiological data analysis and risk assessment experts. It presents challenges around public communication and messaging around risk, with the potential for misinformation and disinformation. Therefore, integrated operational research and intervention, learning from experiences across different fields and settings should contribute towards better understanding and managing COVID-19. This Research Topic aims to highlight interdisciplinary research approaches deployed during the COVID-19 epidemic, addressing knowledge gaps and generating evidence for its improved management and control. It will incorporate critical, theoretically informed and empirically grounded original research contributions using diverse approaches, experimental, observational and intervention studies, conceptual framing, expert opinions and reviews from across the world. The Research Topic proposes a multi-dimensional approach to improving the management of COVID-19 with scientific contributions from all areas of virology, immunology, clinical microbiology, epidemiology, therapeutics, communications as well as infection prevention and public health risk assessment and management studies.

The National Centre for Infectious Diseases (NCID) is the result of many years in the planning, and it finally officially opened its doors in September 2019, just months before the entire world was tested by the COVID-19 pandemic. This book is the work of many people who represent an even larger pool of people from NCID, Singapore and the rest of the world in trying to understand and contain the SARS- CoV-2 virus. There are chapters on science, the public health response both locally and globally, as well as personal reflections from NCID and Tan Tock Seng Hospital staff and staff from other public healthcare institutions who were deployed to NCID which bring home the human impact of the pandemic. We are very grateful to all the authors for taking the time to put together their thoughtful chapters as well as the senior academics and public health leaders who have provided us with generous comments on the manuscript. We hope that the readers of the book will gain a better insight into the response to the virus from so many different perspectives. Although the pandemic has evolved far beyond the pages of this book globally, the lessons learned from the early days are still relevant. We hope that the chapters will be helpful as we review our experience of this pandemic and face the next emerging infectious disease in the years to come.This book provides a comprehensive look at many different aspects of response in Singapore to the pandemic in the crucial first several months, including clinical, laboratory, epidemiology, research, community engagement and the unprecedented challenge of outbreak involving migrant workers in dormitory settings. On a personal note, it has first-hand accounts of staff at the NCID who were at the forefront of battling COVID-19 in Singapore. It also gives a global perspective of the pandemic, together with insights into the unique Singapore experience of managing the pandemic. The Singapore response to the pandemic has been something which the global community has been very interested in and this book is the first to comprehensively describe that response from a number of different angles which will be useful to scientists, clinicians, public health professionals and policy makers.