Global Health II: Globalization and Pandemics

Globalization and Infectious Disease

*Smallpox

Variola virus

Endemic disease

Periodic epidemics

30% death rate

70% recover with natural immunity

Preventative measures

Variolation

Vaccination

Corona Viruses

Common cold

*“SARS,” 2002-2003

Severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1)

*“COVID-19” (Coronavirus disease 2019)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

*Zoonotic diseases

Origin in bats? Jump to civets or raccoon dogs?

Jump to humans in South China

Table 1: SARS vs. COVID-19 Cases and Deaths

  "SARS" 2002-2003 "COVID-19" to Nov. 12, 2020 "COVID-19" to Nov. 22, 2021 "COVID-19" to Nov. 18, 2022
Total Cumulative Cases worldwide 8,098 52.9 million 257 million 637 miilion
Nations & Territories with cases 37 206 227 236
Deaths worldwide 774 1.2 million 5.1 million 6.6 million

Table 2: SARS vs. COVID-19 Death Rates in Countries with SARS

Population

 "SARS" 2002-2003 "COVID-19" to Nov. 12, 2020 "COVID-19" to Nov. 22, 2021 "COVID-19" to Nov. 18, 2022

Worldwide

 9.55% 2.26% 2.00% 1.04%

Canada

 9.3% 3.89% 1.67% 1.08%

Hong Kong

 15% 2.0% 1.72% 0.53%

Taiwan

 13% 1.19% 5.13% 0.01%

Singapore

 14% 0.05% 0.26% 0.08%

Vietnam

 9.7% 2.79% 2.17% 0.38%

Tables 1 and 2 Source on SARS: https://www.who.int/publications/i/item/consensus-document-on-the-epidemiology-of-severe-acute-respiratory-syndrome-(-sars)

Tables 1 and 2 Sources on COVID-19: https://covid19.who.int/table

https://www.nytimes.com/interactive/2021/world/covid-cases.html

Variables Affecting Extent and Intensity of Pandemic

Characteristics of the virus

SARS COVID-19
Flu-like symptoms Flu-like and other symptoms
Symptomatic transmission Asymptomatic transmission
  Receptor spikes

Individual characteristics

Age

Health

National characteristics

Pre-existing immunity in populace?

Population density

Cultural practices

College Halloween parties

Bows vs. hugs

Medical care system quality

Public health system (vaccinations, masks, etc.)

Discussion

Youde, pp. 29-47, 56-59; Buckley, "25 Days That Changed the World"; Brown and Ladwig "Covid-19, China, the World Health Organization"

Why is case of smallpox a hopeful case demonstrating the potential of global cooperation to eliminate dangerous diseases?

How do the cases of SARS and COVID-19 demonstrate the potential of globalization to intensify pandemics?

How was China’s response to COVID-19 an improvement over SARS?

What factors caused the failure of the Chinese government to prevent the global spread of COVID-19?

What cultural norms and institutional factors were involved?

How effective were the World Health Organization's responses to the outbreaks of SARS and COVID-19?

Smallpox Eradication

World Health Assembly (WHA) approved eradication campaign, 1959

World Health Organization (WHO) provided technical assistance and training

National governments carried out vaccination campaigns

Progress of eradication campaign

Central and West Africa, 1963

Asia, 1975

East Africa, 1979

Table 3: “SARS” Pandemic: Timeline of events, 2002-2003 (Based on Youde, pp. 40-45)

Event Time
Outbreak in South China November 2002
WHO requests info from Chinese govt. I Dec. 2002
WHO requests info from Chinese govt. II Feb. 10, 2003
Wedding at Hotel Metropole, Hong Kong Feb. 21, 2003
Spread to Vietnam, Singapore and Canada begins Feb. 26, 2003
WHO identifies and names SARS March 10, 2003
WHO issues global health alert March 12, 2003
China declares National War on SARS April 16, 2003

Table 4: “COVID-19” Pandemic Origins in Wuhan: Timeline of events, 2019-2020

Event Time
Earliest cases in Wuhan mainly in vicinity of Huanan Market Dec. 2019
8 Doctors report SARS outbreak on social media Dec. 30, 2019
Police warn doctors about spreading “rumors” Jan. 1, 2020
CCDC experts visit Wuhan Jan. 1, 2020
CCDC experts visit Wuhan again Jan. 8, 2020
CCDC identifies novel coronavirus & publishes genome Jan. 8, 2020
CCP Provincial conference taking place in Wuhan Jan. 12-17, 2020
Local health officials claim no human transmission Jan. 15, 2020
Dr. Zhong Nanshan visits Wuhan Jan. 19, 2020
Central government begins planning public health action Jan. 20, 2020
Wuhan locked down Jan. 22, 2020
WHO team visits Wuhan Jan. 20-22, 2020
WHO deadlocked on declaring Public Health Emergency of Intl. Concern Jan. 23, 2020
13 Chinese provinces begin public health mobilization Jan. 24, 2020
WHO declares Public Health Emergency of Intl. Concern Jan. 30, 2020

Tables 3 and 4 Sources:

Liu, Yu, and Richard B. Saltman. "Policy Lessons from Early Reactions to the Covid-19 Virus in China." American Journal of Public Health 110, no. 8 (2020): 1145-48.

Brown, Theodore M., and Susan Ladwig. "Covid-19, China, the World Health Organization, and the Limits of International Health Diplomacy." American Journal of Public Health 110.8 (2020): 1149-51.

Buckley, Chris, et al. "25 Days That Changed the World: How Covid-19 Slipped China’s Grasp." New York Times, Late Edition, Dec 30, 2020;

Worobey, Michael. "Dissecting the Early Covid-19 Cases in Wuhan." Science, First Release, November 18, 2021.

Worobey, Michael, et al. "The Huanan Seafood Wholesale Market in Wuhan was the Early Epicenter of the COVID-19 Pandemic." Science 377, no. 6609 (2022/08/26 2022): 951-59.