The Year of the Rabbit and the COVID Pandemic

The rabbit is the fourth animal in the cycle of animals in the Chinese Zodiac, but in the Vietnamese Zodiac, the cat takes its place. In the Great Race, at the beginning of time to the palace of the Jade Emperor, the rabbit came in fourth, after the tiger. The rabbit was fast and was able to cross the river at the end of the race by hopping from stone to stone. Now, it is believed that people born in the Year of the Rabbit are gentle and approachable. They have a decent, noble, and elegant manner. This is the way public health workers should be, caring and rapidly responding to health threats to our communities. Rabbits are friendly, have soft fur, and are adored by children all over the world. The story of Peter Rabbit by Beatrix Potter was first published in 1901 and has been loved by children all over the world. More than 45 million copies have been sold and it is translated into 36 languages, including all the major Asian languages. There are films and television shows about Peter and his friends on Farmer MacGregor’s property. No doubt the year of the rabbit will bring renewed interest in the charming stories of Peter Rabbit, but we are more interested in the role of rabbits in public health and medical research.

Rabbits have been bred and used for food for thousands of years. In many countries, rabbit meat is a delicacy and is a favorite in Spain. The Food and Agriculture Organization has promoted their use and has published guides for raising rabbits in low-income countries. A review of more than 50 studies of rabbit meat described its nutritional value. It is a good source of high-quality protein with a lower sodium content than comparable products.¹ There will have to be extensive changes in meat production if the world is to achieve climate change targets, and rabbits could play a part in reducing the large methane and CO₂ production of cattle needed to supply the world with protein.² If this dream is be realized, there will be a need for greater scale production and improvements in the supply chain.³

In Australia, rabbits were introduced by European settlers and rapidly reproduced to become an agricultural pest all over the country, destroying pastures and crops. The first group of 13 were introduced in 1858 for hunting, but spread all over Australia and grew to a population of 200 million in 50 years. While some were eaten for food, their numbers only declined when viruses lethal to rabbits were identified in Europe and brought to Australia. During periods of economic hardship, such as the Great Depression, they became a valued food resource and their fur was used in clothing and blankets for warmth.⁴ Pet rabbits have been used for support in patients suffering from psychological trauma, and when kept as a pet, they have a life expectancy in the range of 5 to 10 years.

Rabbits have made a major contribution to biomedicine research. While mice are still the most widely used research animal because of cost and availability, laboratory rabbits have many advantages as a model for human disease. They are much larger than mice, relatively docile, and easy to handle and to take blood samples or give intravenous injections. They are easily bred and maintained.⁵ Transgenic rabbits are used in human-related medical research and rapid progress is being made in cloning rabbits, which will further increase their research.⁶ The first notable example of rabbits being used in medical research is in the development of a rabies vaccine by the French pioneer medical scientist Lois Pasteur in the 1880s. The rabbit has continued to be used in vaccine research and more recently in developing monoclonal antibodies.⁷ Some of the diseases that have used rabbits in research on etiology and therapy are syphilis, tuberculosis, HIV-AIDS, acute hepatic failure, and diseases caused by noroviruses, ocular herpes, and papillomaviruses. Rabbits are currently being used to research tuberculosis, which continues to be an important disease in the Asia-Pacific region. There is a need for an effective tuberculosis vaccine for children.⁸ Adenoviruses are very common in human populations and cause a wide range of diseases from mild respiratory tract symptoms to fatal disease in immunocompromised patients. Unlike a number of other small DNA viruses, such as human papillomavirus, adenoviruses are not known to cause human cancer. While the ideal model for adenovirus research has yet to be identified, the rabbit has proved to be useful.^9,10

COVID-19 has dominated the thoughts and work of public health workers for the past three years and continues to be a major cause of morbidity and mortality, along with economic and social disruption. Until now, the great influenza pandemic of 1918-1919 has been the largest to hit humans and probably caused 50 million deaths.¹¹ To date (November 2022), the number of global deaths recorded is 6.6 million, which is likely to be an underestimate with at least another 10 million deaths going unrecorded.¹² Extrapolating the data to the end of 2022, these figures suggest that the true number of deaths is likely to be closer to 20 million. The advent of vaccinations against COVID-19 is estimated to have averted approximately 20 million deaths to the end of 2021.¹³ These numbers are in the same order of magnitude to the Great Influenza Epidemic, and when the experience of COVID-19 in 2022 and 2023 is fully accounted for, it may prove to be the greatest epidemic of all time. The need for intensive research into COVID-19 continues and now it has been shown that laboratory rabbits can be infected with the COVID-19 virus, providing a very useful model. While this can be done in the laboratory, there is no evidence yet that rabbits can transmit COVID-19 to humans in the wild.^14,15

During 2023, our journal the Asia Pacific Journal of Public Health (APJPH) will continue to publish the latest research and reviews on public health in the Asia-Pacific Region. We hope to continue to publish many more articles on the public health impact of COVID-19 in our region. It is likely that long COVID-19 will have a major impact in our region and we want to continue to document the problems it is causing along with validated therapies.

We are also pleased to announce that SAGE Publishing, our publisher, has offered to provide limited Language Editing Services to researchers who are publishing in our journal. We understand that for many public health researchers in our region, English is not their first language and this leads to problems in getting their work accepted. In this two-year pilot that is due to start in January 2023 and continue until December 2024, APJPH will receive a maximum of 10 Language Editing waivers per year to use at the editors’ discretion. Each waiver offers a Premium service with Editage, providing feedback and suggestions on the researchers’ writing by subject matter experts and allowing multiple revisions, thereby delivering manuscripts meeting the international standards of publication. We hope this initiative will be helpful to the diverse author base of APJPH.