What is the CoVERS study?

The CoVERS study, run by the Runstadler lab at Cummings School of Veterinary Medicine at Tufts University, seeks to monitor SARS-CoV-2/COVID-19 infection and transmission at the human-animal interface. This study 1) collects nasal and oral swabs from diverse species that we hypothesize are susceptible to coronavirus infection, 2) tests those swabs using a dual screen RT-PCR, 3) sequences the viral genome from presumptive positives, and 4) tests if presumptive positive virus is viable using in vitro techniques.

Together, these data help us understand what species can get this coronavirus, if animals can further transmit it to other animals, if the virus causes disease in some animals, and if the virus needs to mutate to infect different species.

We are currently screening domestic pets and livestock for coronavirus infection to learn if 1) domestic species are able to be infected, 2) if infection is correlated to disease/symptoms in these species, and 3) how human-animal interactions affect transmission.

We hope to expand to pet owners in the future.

What is the coronavirus?

Coronaviruses are a large family of viruses that can infect a variety of animal species, including humans. In humans, most coronaviruses cause mild respiratory disease and are part of a group of viruses that cause the common cold. There are also many other kinds of coronaviruses that live in animal “reservoirs,” in which they are able to infect and transmit, but not cause disease in that species. When a virus in a reservoir species is transmitted into a new species and causes disease, it is called a “spillover” event.

The current COVID-19 pandemic was caused by a spillover event from an unknown animal into humans, likely in the Wuhan region of China in mid-November 2019. This virus is now named SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), because it is genetically related to the 2003 SARS-coronavirus. Thus far, SARS-CoV-2 appears highly transmissible and able to cause more severe disease than most of the coronaviruses already circulating in humans.

The currently known symptoms of COVID-19, the disease caused by SARS-CoV-2, are primarily fever (87.9%) and dry cough (67.7%). Additional, but less common symptoms, may include fatigue (38.1%), sputum/phlegm (33.4%), shortness of breath (18.6%), muscle pain (14.8%), sore throat (13.9%), headache (13.6%), and chills (11.4%).

Can my dog/cat/horse/animal get the coronavirus?

The American Veterinary Medical Association reports that, infectious disease experts and multiple international and domestic human and animal health organizations agree there is no evidence at this point to indicate that pets become ill with COVID-19 or that they spread it to other animals, including people.

But can domestic animals be infected without showing symptoms? We don’t know. During the 2003 SARS-CoV outbreak, some cats, dogs, and rats were found to be infected. During the COVID-19 outbreak, there have been news reports that two dogs (both in Hong Kong) and two cats (one in Belgium and one in Hong Kong) tested positive for the COVID-19 virus, but there were no clear clinical signs of disease. The USDA National Veterinary Services Laboratories has recently confirmed the presence of SARS-CoV-2, the coronavirus causing COVID-19, in one tiger at a zoo in New York. Other tigers and lions also showed symptoms but were not tested. Another study identified coronavirus antibodies in otherwise healthy cats in a shelter. These reports suggest that cats and dogs could be infected by coronavirus.

We hypothesize that many species, especially those with close contact to humans, are susceptible to infection. This study will be gathering data to investigate all these questions.

Whose animals can be a part of the study?

Right now we are only recruiting patients visiting Cummings Veterinary Medical Center at Tufts University for emergency care. We are happy to include most pets, including dogs, cats, rabbits, chickens, hamsters, gerbils, mice, rats, horses, pig, sheep, cattle, and other species. For the safety of our veterinary staff, we will not enroll animals who are aggressive and pose a serious bite risk.

Do I have to be sick for my animal to be included in the study?

No, it is valuable for us to test animals with owners who feel healthy, too. The current best understanding of the coronavirus is that some people can have the virus without feeling any symptoms. We therefore are using a “surveillance” approach for screening—testing animals regardless of if they or their owners have symptoms of illness.

What do I have to do for my animal to be included in the study?

You must opt in to participate in the study and consent to let your animal have a nasal and/or oral swab.

Your participation details then will depend on which part of the study you’re involved in. For most people, we expect participation will take 10 to 15 minutes.

In most cases, we will ask for your email address so we can send you a survey. This survey will ask if you would like your results back and a preferred method of contact. You are not required to receive your results if you do not want them. The survey also will ask about your interactions with your animal and your animal’s interactions with other animals outside the home, as well as for some basic personal information (e.g. town, age range).

Information for people who wish to enroll their animals through the home monitoring study will be added as soon as it’s available.

What will you learn from the survey and nose and mouth swabs?

We use nasal and oral swabs to see if we can detect any coronavirus on them, and to better understand how this virus spreads and changes.

Your survey results will be used to see if there are behaviors that might increase the risk of coronavirus transmission from humans to animals. We can also use these results to see if there may be coronavirus in areas that don’t know it yet.

Will you give me my animal's results?

Yes, unless you opt out at the time of enrollment or let us know you do not want your results by phone or email. Following screening, we will contact you by your preferred method to give you your animal’s results. Please remember that results from this study are considered research-grade only.

Why don't you call your results conclusive or confirmed?

In order for animal or human diagnostic assays to be considered appropriate for clinical use, the FDA (human) or USDA (animal) must approve all aspects of the test, from the components of the kit to the machines and software used to measure output. In an epidemic situation, the CDC has additional supervisory and regulatory responsibilities. The CDC has issued guidance for laboratories which we follow to the best of our abilities, but we do not have the CDC “RT-PCR kit” nor the specific model of equipment they require. Importantly, clinical-grade tests can only be performed in CLIA-certified labs. We are an academic research lab and not CLIA-certified, and the tests we are running are not FDA, USDA or CDC-approved. Our tests and results are research-grade only and more likely to include incorrect or inaccurate results (i.e. false positives and false negatives).

What is your protocol?

Swabs are collected from any species of animal that is enrolled in the study through Cummings Veterinary Medical Center at Tufts University. We collect one nasal swab and one oral swab taken (in order of preference) from the throat, cheek, saliva, or near the mouth, at our veterinary staff’s discretion. Both swabs are placed in a vial with viral transport media and held in a cooler <12 hours for collection.

When samples get to the lab, we perform RNA extraction in BSL2+ conditions and perform semi-quantitative real-time reverse-transcription polymerase chain reaction (RT-PCR) using reagents that target and amplify a signal only from SARS-CoV-2 viral RNA. We are using primers designed by Corman et al, which the WHO has listed as viable protocol. This primer set has been widely used in Europe and has been popularly called other names including the EU test and the WHO test. We perform preliminary screening on all samples for the viral E gene and a beta-actin internal control that has been designed to cover all relevant species. Samples that are positive by the preliminary screen are re-tested for viral RdRP gene with internal beta-actin control. Samples with good internal controls that are positive for both E and RdRP are presumptive positive.

All presumptive positive samples will be further investigated by culture and sequencing. In vitro culture will take place under secure BSL3 conditions at the Tufts New England Regional Biosafety Laboratory. Swab media will be added to Vero and 293T cells to determine if virus is viable. Previously extracted RNA will be used to PCR amplify and sequence ~350bp fragments using the ARTIC Network protocol and RAMPART-based sequencing on the Oxford Nanopore Technology MinION platform.

We are committed to full transparency for our study protocol as best practices or in-house procedures may change in this dynamic, pandemic situation. Our detailed protocol including all kits and equipment is available here. We will keep all protocols available and may segregate results based on the protocol used, if it becomes important to interpreting the data.

Will I be contacted after receiving my animal's results?

After you receive your animal’s coronavirus results, we may follow up with you at a later point in time for more information for research purposes only. You are not required to respond to any communications from CoVERS.

What will happen to my animal's sample(s) after the study?

We will remove all personal information from your animal’s sample and store it in our secure freezers so that researchers can use it in the future, unless you request otherwise.

Why are you testing animals during an epidemic?

Are you using testing supplies that could be used to diagnose people or you could give to state, clinical, or hospital labs?

We are not. We believe that human testing should be top priority right now. Unfortunately, the reagents (ingredients) and equipment we use are not approved by the FDA for clinical use, even under current emergency use authorization, and we do not anticipate this will change. We have donated and will continue to donate what material, equipment, and personal protective equipment (PPE) we can to Tufts Medical Center and other local hospitals.

What can I do to help stop the spread of the coronavirus?

To help your community “flatten the curve“:

  • Practice social distancing, avoid visiting friends, and do not allow others into your home.
  • Limit travel outside the home, even if you don’t feel sick.
  • Do not join gatherings of more than a few people and remove yourself from any gathering where someone exhibits symptoms of illness.

To prevent COVID-19:

  • Wash your hands frequently with soap, scrubbing for at least 20 seconds.
  • When hand washing is not available, use hand sanitizer after touching objects in public such as door handles or shopping carts.
  • Avoid touching your face, especially near the eyes and mouth. (Sorry, we know this one’s tough! Protip: If you have long hair, wear it up and out of your face.)

If you feel sick right now and it is not severe or an emergency:

  • Contact your physician or local department of public health to determine if you should get a federally approved coronavirus test or need additional medical care.
  • Self-isolate as much as possible for 14 days or until you get back a confirmed negative result from a federally approved test.
  • Cough and sneeze into a tissue or your elbow. Wash your hands and arm frequently.
  • If possible, separate yourself from others in your household, ideally using a separate room and bathroom.
  • Use a face mask to avoid spreading droplets via coughing or sneezing if you live with others or must go into public.

If you have having a medical emergency, always call 9-1-1.
If you are seeking medical guidance for yourself, we recommend that you speak directly with your physician or call the Massachusetts COVID-19 information line at 1-877-211-6277.

More information can be found at the Mass.gov and Centers for Disease Control and Prevention COVID-19 resource sites.

Who do I contact with questions?

If you have any questions or comments, please email coversstudy@tufts.edu or call 508-839-8775.

If you are a clinic or research lab interested in collaboration or data sharing, please contact Kaitlin Sawatzki for animal inquiries or Nichola Hill for human subject inquiries, by email or phone, at 508-263-0074.

If you have other questions about the study or represent a media organization, please contact Jonathan Runstadler, by email or phone, at 508-887-4552.