The E word as again taken the glocal headlines by storm this past month, causing fear, panic and raising the ever important question of what now? The word I am referring to of course is Epidemic. This post is to answer some of the more political based questions posed by epidemics, and most recently, the coronavirus. Here we are going to break down what epidemics are, the responsibilities of nations, international relations over epidemics and the political side effects. We trawled through journals, news websites and podcasts to get the most accurate and unbiased information for you, to get a good understanding of this terrible epidemic and the implications it holds on the global stage. Unfortunately what we lack currently is up to date information. The current information we have on the illness is controlled by the Chinese State.
To put infectious diseases into perspective, they are responsible for around 25% of global deaths annually. Disease outbreaks have become increasingly frequent and ubiquitous over the last couple of decades. We, as a race are no stranger to epidemics, but they are not made equally, with some epidemics terrorising the headlines more than others. Most notable epidemics that have plagued our headlines have been Zika, Ebola and SARS, to name a few. The end of 2019 saw the first cases of what has now been identified as the COVID-19 strand of the Coronavirus. Coronavirus has had previous outbreaks in modern society, most notably the 2003 SARS outbreak.
But what is an epidemic? The World Health Organisation (WHO) defines an epidemic as:
“The occurrence in a community or region of cases of an illness, specific health-related behaviour, or other health-related events clearly in excess of normal expectancy. The community or region and the period in which the cases occur are specified precisely. The number of cases indicating the presence of an epidemic varies according to the agent, size, and type of population exposed, previous experience or lack of exposure to the disease, and time and place of occurrence.”
Epidemics are not necessarily new illnesses, only ones that aren’t managed. For example, in many western countries during what is colloquially called “flu season” Flu, a strand of the Influenza virus (either re-occuring or new) turns to an epidemic state. When H1N1 flu started in the United States in 2009, “it infected more than 1.6 million and took some 284,500 lives across 214 countries, with a morbidity rate of 17.4%. Global reactions to the H1N1 flu were less hysterical and critical, compared to the coronavirus, which is said to have a 2.1% mortality rate among those infected.”  However, as it is managed in the sense that it can be prevented and cured reasonably, it is not deemed as high a concern as unfamiliar or uncommonly named illness. The current outbreak of Coronavirus has been described from WHO as a global health emergency under its current epidemic status (February 13th 2020).
National Responsibility as outlined by WHO as part of the International Health Regulations in full can be found here:
A Case Study of Failure: Ebola
To truly understand the implications of epidemics on a national and global stage, let’s look at some of the notable cases of the 2010s. February 2014 saw the start of terrifying Ebola outbreak in Western Africa. This epidemic is the perfect example of the collective failure to identify, respond to and control an epidemic. “Actions taken nationally and internationally deviated from the strategy that the international community designed, built, and implemented over 20 years to manage threats to global
health security.” The strand of the 2014-2016 outbreak is considered to be the most fatal of it’s viral family, known as Zaire ebolavirus. During this outbreak it is thought that around 28,600 people became infected with 11,000 cases resulting in death. Ebola has been an identified virus since 1976, however previous to 2014, ebola outbreaks have been confined to remote areas that were easily contained within the African continent. What makes the 2014 outbreak so severe is the failure to identify the virus before carriers spread it across western africa, and with the aid of modern transportation, across to different continents.
Reasons for this particular outbreak rest on national infrastructure within Sierra Leone, Liberia and Guinea at the time. All the aforementioned West-African countries were still emerging from civil wars, with support from the U.N.’s Peacebuilding Commission. The governments of these countries were still unstable with a lot of emphasis on tribalism rather than the western concept of nationalism. Unfortunately the lack of consistent infrastructure including the severe lack of medical resources and treatment centres have been a main reason for the ill-containment of the 2014 outbreak. Most of the health centres in the regions were either severely damaged or lacking in professionals. Adding to the poor infrastructure, the lack of decent transportation and roads meant that patients were not able to get to health centres, tests and results took long periods of time and communicating to the public about health emergencies became very difficult. Another factor towards the outbreak is cultural practises around the deceased. A majority of the cultural burial practises in the area involved extensive contact with the deceased. In Ebola in particular, cadavres are well known for their infectious nature, meaning that these cultural practices unfortunately underpinned the the spread of the illness. The Ebola virus is highly contagious, being spread through direct contact with bodily fluids, including and not limited to; vomit, diarrhea and blood.
Prior to the arise of the Ebola virus in these nations, the virus had been a cause to outbreaks in central Africa, these countries at the time being more familiar and prepared for the disease. To Western Africa, Ebola was a mysterious disease, the first case being identified 3 months after it’s presentation, meaning that by the time that WHO was informed of the appearance of Ebola in a new region, it was too late to contain the disease to the area of patient zero.
The 2014 Ebola outbreak is an extreme example of how epidemics can undermine healthcare systems by disproportionately targeting healthcare professionals. As healthcare workers were in close proximity to the “mysterious disease” which turned out to be the highly contagious Ebola, they fell ill in greater numbers, depriving the short-staffed healthcare centers of yet more staff. This demoralised many healthcare workers, leading to yet more shortages of staff. It is thought that at the time there was a doctor to patient ratio of 2:100,000.
All in all, the 2014 Ebola epidemic is a symptom of a weak health-care system, and a poor national response. Proving that infrastructure and prompt national response are imperative in containing infectious diseases. With proper supplies and trained personnel, the disease could have a 90% cure rate.
Coronavirus: What has China done to contain COVID-19?
The new outbreak of COVID-19 has shown the world what China can do in terms of logistics and infrastructure, building a fully functioning 1000-bed hospital within 2 weeks, in the affected city of Wuhan. Other facilities such as a gymnasium and disused factories have also been converted into health centres to treat patients and contain the illness. The scale of this building would usually take several months in a country like the U.K. or U.S.A. To help contain the spread of the virus, surveillance drones have been ordering citizens to wear masks, and those who aren’t are being asked where theirs are. Certain cities and areas within China have placed restrictions in terms of travel and everyday life, the epicentre of the disease, the city of Wuhan has been placed in a military-esque lockdown. Yet, the virus at current has been identified in 24 countries outside of China since it’s initial reporting, with a rising death toll of 1370. For a disease that’s about the same contagiousness than the flu, how has it reached the level of an acute pandemic?
Only within the recent days have reports started to come out of China downplaying the severity of this strain of Coronavirus. Early signs of the outbreak date back to December 1st 2019, with doctors being told to stop warning others of the potential infection. News stories about the disease were censored from the public domain, and the severity of the illness was downplayed. However, due to clinical testing to confirm cases, the numbers given initially in terms of people affected have not been accurate on a day to day basis, many cases being retrospectively reported, hence the spike in cases seemingly overnight. In a WHO official press conference in Geneva, experts have confirmed that professionals only recently (12/02/2020) can identify and legitimately confirm cases via X-ray, without having lab confirmation, meaning that processing time from treatment to diagnosis to reporting has increased a substantial rate. This means that the reported number of confirmed cases from the Hubei Province will exponentially increase due to the new ability to diagnose COVID-19 clinically. 
Data and resources coming out of China can not be wholly trusted due to the nature of data secrecy within China. After the 2003 SARS outbreak in mainland China, the Chinese government held important accurate information pertaining to the outbreak secret. There were also huge infrastructural issues in terms of communications back in 2003, with a mere 6% of the population having internet access. This led to the SARS epidemic as there was a lack of initial news and containment, allowing the disease to spread, making it harder to be contained. Jump forward to 2020, there is still a black-hole in some communications and data access, but it is thought that 60% of the population now have internet access , meaning that news about the disease can be proliferated easier. (But unfortunately not all of it is true or accurate). However, this does not mean that Chinese officials had learnt from past mistakes. tensions within the Chinese government led to what is know as “tossing the wok”, or passing the blame and responsibility onto someone else.*
Healthcare workers in Wuhan have particularly been at risk of contracting COVID-19, papers publishing that over 1700 professionals have been infected with at least 6 deaths. It is thought that in China at current, the doctor to resident ratio sits at 2:10,000, with an augmenting shortage of masks and protective gear for healthcare workers. With the additional long hours and psychological depletion of treating COVID-19 patients, healthcare workers are becoming more susceptible to the virus. 
What does this tell us about COVID-19? If doctors were treated seriously, and not told to keep quiet about the initial cases, the global state of emergency could have been avoided completely. However, the way that the virus is now being handled within Hubei province shows efficiency in creating and managing the appropriate infrastructure, as well as efficiency in clinical progression in terms of diagnosis. The current state of healthcare workers and resources also shows that without support and proper equipment, the virus can quickly break out of containment. As with all epidemics, it could have been avoided if the first response on a national scale had been serious and swift.
International Relations and Responsibility
This is where WHO, the World Health Organisation step in. The organisation has drawn up many plans on how to stem and manage epidemics, via the International Health Regulations. The regulations came about “In response to the exponential increase in international travel and trade, and emergence and reemergence of international disease threats and other health risks, 196 countries across the globe have agreed to implement the International Health Regulations (2005) (IHR). This binding instrument of international law entered into force on 15 June 2007.“ The main responsibility of these laws are “to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.”
The regulations are laid out, but applying them to reality is a different matter. A lot of nations have taken considerable action to contain the virus to China, including travel and trade bans, as well as quarantining individuals who have been extracted from the infected areas. Economic support has also been offered towards containing the disease from various countries.
The European Union’s Response (so far)
Of current, only 25 cases have been identified in Europe. In nine of these cases, the virus was acquired in the continent – eight in Germany and one in France – but the rest is imported from elsewhere. To date 447 european citizens have been extradited from infected regions. The Majority are being subjected to 14 days of quarantine before being allowed to go back and resume normal life, in their respectable countries. 
The European Commission on the 31st January 2020 announced support to the research into coronavirus vaccine with €10m from its research and innovation programme.
The U.S. Response (so far)
The Centers for Disease Control and Prevention (CDC), a part of the Department of Health and Human Services (HHS), has been the the U.S.’s first responder to the coronavirus outbreak. Since it’s initial report, the CDC have implemented measures such as screening and banning travellers who have recently been to China, operating quarantine for these individuals and educating professionals on the symptoms and containment of the disease within the United States. The CDC have also been working on testing kits to easily identify the virus without lab confirmation. Unfortunately, a federal response has not been organised of yet due to the disbandment of a global health team on the National Security Council in 2018 by the Trump administration.
Some U.S. companies have also banned trade and travel to China, including the cancellation of all United Airline flights to China until April. This comes with a significant decrease of planned flights between the States and mainland China.
Overall, International response has been fairly positive, with countries sensibly implanting quarantine and limiting travel to contain the disease. However, by having total bans on travel can cause for people to enter countries illegally meaning that the virus can be spread this way, yet the likelihood of this happening is very low.
Politics, IR and Economy – The Side Effects
China has basically shut down. The aftermath in this halt of production including the decrease in oil prices, having fallen 20% over the past month based on the expectations of a lower demand from China coupled with reduced sales of jet fuel as flights are grounded. Press reports suggest that China’s daily crude-oil consumption has indeed fallen by 20%. That amount is equal to the consumption of both the United Kingdom and Italy combined. In response, OPEC and Russian officials are now debating whether to cut oil production to buoy prices. Prices for metals and other construction resources have also decreased. As many of these resources are from mines from Latin America, countries like Chile are also expected to take a hit on their GDP this year. China is known for being responsible for exporting 30% of the world’s electronics , in terms of parts and assembly. Companies such as Apple rely on these parts to ship globally, meaning the tech sector could take a big hit if the virus continues to spread at the current rate.
The following chart, taken from the financial times shows how imperative China’s electronic exports are for the global market:
Many countries have taken different approaches on issues such as travel or trade restrictions – an action that has inevitably hit the Chinese stock and commodity markets.
Predictions of auto sales dropping more than 10% in the first half of this year, and around 5% for the whole year, are among some of the predicted falls in Chinese economy.
It is not just China who are facing economic slow downs due to COVID-19. Companies in other countries who are dependent on Chinese supply chains are feeling the effects. Countries who have imposed travel restrictions including: Japan, Australia, New Zealand, Singapore, Italy and the U.S are amongst those who will be affected. Asian countries will especially see a sharp reduction in tourism, as Chinese tourists fuel a majority of the economy is countries such as Cambodia and Thailand. An estimate of 163 million Chinese tourists in 2018 accounted for just under a third of retail travel sales globally. In Thailand, for example, the government has already reduced its 2020 GDP forecast, based on expected revenue losses, up to $1.6 billion from 2 million fewer Chinese visitors, should the virus continue past April.
Overall, the economic effect from China’s shut down has and will effect the rest of the world. Some countries will feel the strain more than others, and it is not clear to what extent COVID-19 will effect the global economy, but for now we can enjoy cheaper oil and raw materials.
Epidemics are not limited to causing destruction to human life. They can cause a massive shift in the world economy as well as how countries are viewed in International Relations. They can also cause a lot of fake news, leading to unnecessary widespread hysteria. Not all epidemics are equal, but they can all be contained when dealt with appropriately.
*- We are not going to expand into too much detail about the current Chinese political system.
SARS – Severe Acute Respiratory Syndrome
Dry, Sarah, and Melissa Leach. Epidemics: Science, Governance, and Social Justice. Place of publication not identified: Routledge, 2010.
 Fidler, David P., “Epic Failure of Ebola and Global Health Security” (2015). Articles by Maurer Faculty. Paper 2139. https://www.repository.law.indiana.edu/facpub/2139/
 Fidler, David P., “Epic Failure of Ebola and Global Health Security” (2015). Articles by Maurer Faculty. Paper 2139. https://www.repository.law.indiana.edu/facpub/2139/