Welcome to the first issue of The Lancet Microbe, an open access journal for which we have ambitious plans. Our aim is to publish research that sets this journal apart from others in the clinical microbiology sphere, by catering to work exploring microbes and infectious agents at all scales. We will publish research ranging from the nature of the pathogen (eg, antimicrobial resistance genes or plasmids, virulence factors), to the microbiome, to pathology (including immunology), and to population-level effects (eg, outbreaks, epidemiology). But we will not limit ourselves to this outline: we are motivated by a complete fascination regarding pathogens and will consider any research that adds to the understanding of pathogenic microorganisms or other transmissible agents. Also, in keeping with the ethos of the entire Lancet family, we will strongly advocate for and collaborate with the microbial research community worldwide.
It will come as no surprise that this is a challenging time to launch a medical journal, particularly one focussing on research into pathogens. However, current events have also made it clear that a journal such as ours has arrived just in time to help the microbial research community as it works tirelessly to uncover the inner workings of SARS-CoV-2. Our first issue carries a variety of information on this new virus, from its stability in the environment to its behaviour in numerous cell lines. Furthermore, this issue includes discussion of the need for renewed vigilance around viruses that pose a zoonotic risk, a discussion of ultraviolet light as a sanitising agent, and a call for thorough scrutiny of co-infections in patients with COVID-19.
The first research Article in this issue is by Hin Chu and colleagues and compares the tropism, replication kinetics, and cell damage profile of SARS-CoV-2 with SARS-CoV. Screening 25 human and non-human cell lines, the investigators uncover viral characteristics that potentially reflect the features of COVID-19 and SARS. Of course, we must be cautious when extrapolating disease characteristics from cell culture, but these are nonetheless intriguing insights. Furthermore, research into MERS-CoV showed that results such as these can closely accord with clinical findings. Chu and coworkers find that SARS-CoV-2 has broad affinity for human-derived cell lines, but the virus's most significant replication was in the same cell types favoured by SARS-CoV: pulmonary, intestinal, hepatic, and renal. However, the robust replication of SARS-CoV-2 did not lead to the same levels of cell damage as SARS-CoV. Providing a hint about what might be behind the differing pathogenesis of these two viruses.
The understanding of SARS-CoV-2 has grown at a truly remarkable rate, with researchers scrutinising the virus from every conceivable angle. Our ambition is that The Lancet Microbe will be a venue for work on this virus even when it is no longer newsworthy. Our commitment is to the fullest understanding of pathogens and pathological processes whatever the level of public attention they attract. This pandemic has become the centre of attention for obvious reasons, but this should not detract from attention on other pathogens. They have not disappeared because we have looked away.
The response to the COVID-19 pandemic is genuinely unprecedented, but some of this response carries substantial risks. In an interview published on April 26, Bill Gates stated that the focus of the Bill & Melinda Gates Foundation will now shift entirely to work on addressing the pandemic. This is a risky move because other epidemics have shown that the greatest human cost is often due to their impact on the response to other diseases. For example, the disruption caused by Ebola virus disease in the Democratic Republic of the Congo hampered ongoing work to control measles, with enormous consequences. During the COVID-19 pandemic we are also seeing the undermining of efforts to control preventable diseases.
Much about SARS-CoV-2, and in turn COVID-19, is still unclear and it will take time to fully understand its nature; however, our knowledge of this pathogen can be built on our understanding of its close relatives and the incredible scale of ongoing work. An equally pressing concern is that the urgency of investigations into the nature of SARS-CoV-2 does not entirely overshadow other vital considerations, such as the study of antimicrobial resistance and the panoply of other infectious agents that remain a huge source of suffering. The Lancet Microbe will be here to support those efforts.
For more on the Gates foundation and COVID-19 see https://www.ft.com/content/f4557f2c-2464-46bd-a844-d08cadc3da59
© 2020 David S Goodsell, RCSB Protein Data Bank