In December 2019, a new respiratory virus outbreak began in the Chinese city of Wuhan, Hubei Province. A new strain of coronavirus, designated COVID-2019, belongs to a large family of viruses, causing illnesses ranging from the common cold to more severe cases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The circumstances around the outbreak of the virus suggest animal-to-person spread, with suspected ties to a live animal market. The subsequent expansion of the contagion suggests person-to person spread, which was reported outside China as well, in countries including the United States, South Korea, France, Iran, Japan, the Philippines, Italy, etc.
On January 30 2020, the International Health Regulations Emergency Committee (World Health Organization) “agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern”. On January 31 2020, United States government introduced border-crossing restrictions and limitations, and Centers for Disease Control and Prevention (CDC) issued several travel notices. However, some epidemiologists argue that travel restrictions actually buy little time and cannot serve as a major countermeasure. In addition, the World Health Organization (WHO) does not endorse them.
Speaking of movement restriction, the question of the effectiveness of quarantines and the social policies around them is an important one. In Hubei province, over 50 million people are under strict instructions not to leave their residences. Italy has been implementing lockdown procedures in some of its northern towns, which is already impacting the local economy. Dr. Howard Markel, professor of the history of medicine at the University of Michigan, is generally skeptical of the effectiveness of quarantines, as citizens tolerate them poorly in an already anxiety-inducing situation. However, he adds some “[c]ivic-minded, community-wide, voluntary disease containment and mitigation efforts”, such as in the case of Mexico City during the 2009 H1N1 influenza, have been shown to work well. The question is whether a quarantine can hold in megacities such as Wuhan, or how smoothly can it be implemented in federal republics such as the United States. History of quarantine implementation shows that in many instances, stigmatized groups have been isolated and inappropriately quarantined, with their health needs ignored or worsened, such as gay men and Haitians in the early days of AIDS epidemic in the US, or San Francisco’s Chinatown during the bubonic plague outbreak in 1900.
Global imperialism and capitalism affect the possibilities for virus containment in other ways. Iran now appears to be the epicenter of the outbreak in the Middle East, with a higher fatality rate than seen in other places, and officials running the anti-coronavirus task force contracting the disease themselves, including the Vice President. In October 2019, Human Rights Watch reported that the US economic sanctions were seriously harming Iranians’ right to health, despite the formal humanitarian exemptions. Restrictions on financing imposed by the sanctions have resulted in limiting Iranian companies and hospitals’ options for purchasing essential medicines and medical equipment from abroad – a crucial element for residents’ access to critical medical care. The financial stress on Iran’s nearly universal healthcare coverage was prognosed to likely have “devasting effects on millions of patients”. It would seem that the options for coronavirus outbreak management are in significant part restricted by the sanctions. Another example of the devastating impact of neoliberal policies are austerity measures imposed in the Philippines which have resulted in infrastructural inadequacies to address the health crisis.
Since the outbreak of the virus, public displays of Sinophobia and anti-Asian racism have been reported globally: in the US, UK, Australia, Canada, France, and other places. As Dr. Adia Benton, Associate professor of Anthropology at Northwestern University, said “[t]he coronavirus is new, but not the toxic narratives around it”. Formulaic “outbreak narratives”, in which geographical origins of the disease are coupled with racialization and exoticization of the affected population, promote stereotypical images of specific cultural behaviors, lifestyles and social practices. Such images commonly evoke feelings of disgust, as in the cases of reports on eating habits. Previous cases of global epidemics provide similar examples of rampant white supremacy, othering and racializing populations: SARS outbreak in 2003, H1N1 outbreak in 2009, or the case of Ebola outbreak in 2014.
Additionally, WHO said that the coronavirus outbreak was accompanied by a massive “infodemic” – “an over-abundance of information – some accurate and some not – that makes it hard for people to find trustworthy sources and reliable guidance when they need it.” In response, the WHO enhanced its online presence, with a particular focus on social media channels. Even though recent global epidemics such as MERS, SARS, or Zika were accompanied by a global moral panic, it seems that proliferated social media use enhances this effect. On the other hand, social media has also provided a platform for continuation of daily life under quarantine, as well as practices of mutuality, solidarity, and collective grieving.
A broader issue at hand is the interplay between climate change and the spread of epidemics. Even though the connection is complex and multifactorial, it’s clear that “broadly speaking, climate change is likely to lead to an uptick in future epidemics caused by viruses and other pathogens”. Some research predicts that climate crisis will most likely accelerate the transmission of zoonotic diseases (transmitted between animal and people) by reshaping animal habitats, pushing animals towards new migratory routes and as a result, putting them in contact with new diseases and increasing their stress levels, thereby potentially weakening their immune systems. In addition, as pathogens are gradually exposed to warmer temperatures due to global warming, they become better equipped to survive the high temperature inside the human body – which presents a key adaptation that stimulates our immune systems. As the imposed measures to contain coronavirus in China have resulted in a temporary reduction of CO2 emissions by a quarter, this might be a good time to consider how policies which would reduce working hours and industrial output would have a dramatic impact on the climate, and with it, global health.