Infectious diseases and globalization

The real threat posed by emergent infectious diseases like the novel coronavirus (2019-nCoV), which first appeared last December in China’s Wuhan City and is now causing global concern, is not that it is deadlier than other known viruses or bacteria.

It is rather that while the principal carriers of these diseases—human beings—now travel faster and farther than ever before, the incubation period for infectious diseases have remained the same, slow. Indeed, every year, a far greater number of people die of the common flu all over the world than from any of these newly-discovered pathogens.

Yet, we do not hear of the World Health Organization (WHO) raising an alarm. There must be a good reason for that.

Though influenza and pneumonia can be fatal, particularly to older persons with preexisting health issues, their symptoms are well-known and their progression can be carefully monitored and managed. Laboratory tests can detect their presence in the blood or sputum before the infected person becomes contagious.

Moreover, the right drugs can be prescribed before the disease completely overpowers the patient’s remaining defenses.

Today’s emergent pathogens are less tractable. It is what makes them dangerous. Experts say that their incubation period is slow, and they may mimic the symptoms of other respiratory illnesses.

But their victims may not respond to the usual antibiotics and other medications available in the market. Because they are new, there are no vaccines for them.

More to the point, these new viruses—usually transferred initially from animals to humans and later from human to human—can spread at the same pace as modern travel permits. This is especially true of airborne pathogens.

One infected passenger, an unknowing carrier, in a crowded airplane, can technically infect an entire cabin through incessant sneezing and coughing. In turn, every passenger in that contaminated cabin can transmit the virus, again unknowingly, to the guests of an entire hotel or restaurant.

The incubation period being slow, each one of these individuals might feel well enough to travel to other destinations or to take their return flights, little suspecting that they have become carriers of a virulent pathogen. Many horror movies have captured a nightmarish scenario like this, and perhaps there is none more frightening than the Korean film “Train to Busan.”

It is easy to underestimate the seriousness of these outbreaks of hitherto unknown viruses. For the moment, the latest figures for this new coronavirus do not yet indicate the existence of a full-blown global epidemic. So far, there have been over 1,300 confirmed cases of infection, mostly in China.

But the figures are increasing. Yesterday, Chinese authorities confirmed that 41 people have died from the virus, mainly older people above 60 years of age. Another 8,420 people are under careful observation.

But it’s astonishing how fast the disease has spread beyond China. Infections have now been confirmed in France, South Korea, Japan, Nepal, Thailand, Singapore, Malaysia, Vietnam, Hong Kong, Macau, Taiwan and the United States. China, which had learned a painful lesson from the lack of transparency in the SARS outbreak a few years ago, has vowed to do all it can to contain the global spread of this coronavirus.

It has done so in full acknowledgment of the incontrovertible fact that almost all the confirmed cases of the 2019-nCoV reported outside China involve people who had recently traveled to China, specifically Wuhan.

Chinese authorities have ordered the suspension of public transport in all affected cities, leaving millions of people traveling during the Lunar Chinese New Year holiday stranded.

The government is rushing the construction of a 1,000-bed facility expressly dedicated to the treatment of the victims of this disease. Millions of Wuhan residents have been ordered to stay inside their homes.

It’s difficult to imagine the kind of magnified response to a health crisis and the level of transparency that the Chinese authorities and state media have shown in the past few days.

They used to be extremely secretive and sensitive to any report that hints at an inability to solve the country’s own problems.

It is probably just a matter of time before the Philippines reports its first cases of infection from this coronavirus. Planeloads of Chinese tourists on chartered flights from Wuhan City have arrived in Kalibo, Aklan, headed for Boracay, since at least a week ago.

Philippine authorities have announced that the last of these tourists will be asked to leave the country by Monday, at the latest.

Clearly no government with any sense of responsibility can possibly take this threat lightly, or hide it from the rest of the world for fear of halting tourist travel or triggering an economic meltdown.

Airborne diseases obviously respect no national boundaries. In this age of global travel, the epidemics they create inevitably become equally global. They won’t be effectively contained at the level alone of the nation-state.

The bright side in all this perhaps is that there is now a good chance that the solutions that are coming out of the worldwide response to global epidemics may provide the badly-needed templates for solving the other persistent problems of humanity.

One of these problems, presently very low in the priority scale of the world community, is the unabated trafficking of endangered wild animals.

The novel coronavirus known as the 2019-nCoV has been traced to a market in Wuhan that sells exotic wildlife for human consumption.

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