Coronavirus and its global impact

The Coronavirus – otherwise known as COVID-19 – is already having a truly global impact.

The first cases were reported in the Chinese city of Wuhan back in late December 2019. At the time, it was initially believed to be a form of pneumonia. At least, that was how the Chinese government first reported it to the World Health Organisation (WHO) on December 31st.

Now, around 90 000 globally reported cases and perhaps several thousand deaths later, the virus has spread far beyond China. Italy and Iran are reporting serious outbreaks and major measures being taken to prevent the spread. Numerous other parts of the world are also reporting their first cases.

In these places, anxiety is already driving up panic buying. Especially of essentials like toilet paper. Online shopping is also affected, as are businesses in every sector. Aviation and travel, leisure and entertainment, banking, the technology sector…

One thing is for sure:

Tackling this crisis is going to take a concerted global effort. And, as with all international cooperation, language and the ability to communicate with complete clarity are going to play a major role.

How will the Coronavirus and its global impact be dealt with by medical professionals who speak different languages and hail from different cultures?

             What is the coronavirus?

Even when answering this basic question we see the importance of clear communication and terminology.

Because “the Coronavirus” is not a one-of-a-kind thing. It is, in fact, only one of a whole group of “coronaviruses”. This group, which are similar to influenza in their make-up, contain four which regularly infect humans. Best known among them, the common cold.

The mild symptoms of the common cold are generally supposed to be an advantageously evolved characteristic of viruses such as this. After all, as a virus, killing your host is a bad way to maximise your spread.

Coronaviruses (including COVID-19) spread through people in close proximity. When one inhales droplets from a cough or sneeze or touches a surface where those droplets land and subsequently brings that hand to touch the face or nose.

This new “novel” coronavirus, as it sometimes called – which large parts of the world and the media refer to as simply “the Coronavirus” – is technically called 2019-nCoV. It can cause a respiratory illness which can be severe or even fatal in around 1-2% of cases.

             How does it compare to other major viruses?

Both the SARS (Severe Acute Respiratory Syndrome) outbreak of 2002 and MERS (Middle East Respiratory Syndrome), first reported in Saudi Arabia in 2012, are also coronaviruses. Each of these killed less than 1000 people. Crucially, they did so in fairly predictable, symptomatic ways.

This latest “novel” coronavirus is more of a problem – mainly because it is not predictable. While it has already killed at least twice as many people as the other two major virus outbreaks mentioned here:

  • COVID-19 technically has a lower fatality rate than SARS or MERS
  • Some people may catch it but display no symptoms at all
  • This may make its spread easier and more difficult to contain

It is, in effect, just deadly enough to be really dangerous. It is this unpredictability which may cause medical professionals and researchers even more serious problems than even SARS or MERS.

             COVID-19 regional outbreaks and responses

Following in Chinas’ footsteps, at time of writing, Iran, Italy and South Korea were at the forefront of countries reporting that they had rapidly increasing numbers of “novel” coronavirus infections.

China’s initial response was a never-seen-before (and probably impossible to implement anywhere else in the world) containment and shutdown of almost all interpersonal contact between people in many of its major cities (cities with a combined total population of around 60 million).

Despite this sounding like a good idea to the layman, many experts have critiqued the response as being inefficient and even harmful in many cases. Nevertheless, other countries and regions continue to take these measures.

Limited containment is not necessarily a bad policy, many experts argue. But it is unrealistic to expect cities to remain closed down, panic-bought supplies to last and travel to be kept to zero for a long period of time.

At some point, a truly international response will require clear communication and cooperation across languages and across borders – in the clinical trials and studies which are already being carried out by various organisations around the world.

             The Coronavirus effects across industries

Even in places like the UK, where cases – at time of writing – were around the 100 mark and there were very few cases of reported deaths due to the virus, there are still obvious signals that COVD-19 is and will have an effect across all sectors of the economy.

The UK government has suggested that 1in 5 people may have to take time off, while major employers such as HSBC have started to ask employees to work from home.

In China, Hong Kong, Italy and other places where there are large numbers of cases, the spread of the virus and efforts to contain it have already had a massive impact on people’s lives and jobs.

The Coronavirus has already affected almost every industry:

                Coronavirus effects on air travel and the aviation industry

COVID-19’s effect on air travel has been enormous. Hundreds of flights have been suspended. Several American airlines and others have cancelled flights to China and places near to China, such as Japan and South Korea.

All in all, thousands of flights have been cancelled – and not just to South East Asia. Some carriers no longer travel to Italy, the European country with the highest number of reported cases so far.

Others airlines have waived cancellation fees if passengers wish to change their minds about travelling to countries designated “high risk”.

In the UK, regional airline Flybe has collapsed completely due to the effects of the virus on air travel. The UK government had originally promised to step in and save the airline but changed its mind at the last moment.

Now, thousands of passengers are stranded in various parts of Europe and thousands of jobs have been lost. Numerous others may be at risk at regional airports around the country whose major source of custom and passengers to serve was Flybe.

Various regions of the country – especially Northern Ireland – have already signalled the major problems with connectivity the end of Flybe has left them with. This may lead to significant further loss of jobs and commerce in the future even before a single case of the virus has been reported.

In the US alone, the heavy reduction in Chinese tourism is expected to cost $5 billion in the next year. Although this is a number based on the SARS and MERS outbreaks of 2003 and 2015 – both of which were significantly smaller in spread and scale – and may end up being a conservative figure in the long-term.

                Coronavirus and the entertainment industry

As part of the Chinese government’s crackdown, Disneyland Shanghai closed its doors on 25th January, closely followed by Disneyland Hong Kong. This, at one of the biggest times of the year – the Lunar New Year holiday, which plays a large role in generating the park’s $1 billion in annual revenue. Neither park has stated when they plan to re-open.

The Chinese film industry was also hit instantly. Nearly all cinemas and movie theatres were shut down on the 24th of January. Again, dramatically this affected sales during one of the busiest times of the year. Some figures have shown the usual roughly $1.5 billion Chinese New Year cinema takings were reduced to less than $4 million.

Across the world, the entertainment industry is cancelling events, tours and halting production of everything from local shows to major films.

Artists as musically diverse as Mariah Carey, Green Day, Avril Lavigne, Stormzy, Ruel and New Order have cancelled or postponed gigs due to flight restrictions.

In China alone, more than 20 000 music events have been called off or delayed to the tune of more than $280 million in lost ticket sales. Much like the aviation industry, these lost events and revenue mean lost and endangered jobs as events companies are forced to close down or downsize.

In Europe and especially the UK, industry professionals already worried about the effects of Brexit on their industry – foreseen as making it potentially very difficult for artists to perform overseas, depending on the final deal arrived at by the EU and UK government – now have an even more immediate concern.

                COVID-19 and the leisure industry

In Macau, no official fireworks were let off to mark Chinese New Year. This lack of celebration is perhaps emblematic of the troubles the autonomous region will face with the spread of COVID-19.

The region’s economy is heavily geared towards catering for Chinese tourists who visit in large part to gamble, an activity of dubious legality in mainland China. This has led Macau to be nicknamed “the Las Vegas of Asia”. But in the immediate aftermath of the first cases being reported in China back in late January 2020, foreign tourist numbers in Macau were down somewhere between 60-80% and have shown little sign of recovering.

In China itself, major landmarks were closed down as precautionary measures. These included the Forbidden City, portions of the Great Wall of China, the National Museum and Beijing’s Olympic Stadium.

Hotels – including major chains like the Hilton, Marriott and InterContinental – waived cancellation fees in parts of China for the immediate outbreak period and Airbnb allowed hosts and guests to cancel plans without penalty if their plans were in Hubei province. Hubei is the home of Wuhan and the most seriously affected part of China.

In areas of China where public transport has been closed down, chains like Starbucks and McDonald’s have also closed stores or suspended business.

                The technology industry

Organisations as large as Facebook and Google have cancelled events (in the case of Google I/O, their major news event of the year) or switched international gatherings to being local-only and live-streamed (in the case of Facebook’s F8 developer event).

Plus, China is a major manufacturing hub for all kinds of smartphone companies. Apple is expecting to miss its forecasts for this reason, while smartphone production as a whole is expected to decline heavily (making it the worst quarter for this part of the industry since 2015).

The Hubei province, in particular, is heavily involved in fibre optic production, meaning this industry will take a major hit too.

                The banking industry

Banks and financial sector employers, including HSBC, Credit Suisse and UBS – all of whom have been pushing hard to expand into China in recent years – have been variously telling employees to stay at home for 14 days if they have visited China, to travel only if absolutely necessary or banned travel to China altogether.

                The automotive industry

As well as being vital to the technology sector, the Hubei province plays host to numerous companies in the automotive industry. Nissan, Honda, Renault and many other big names all have manufacturing plants there. As do numerous smaller concerns which manufacture components as part of the larger automotive supply chain.

This is likely to cause major ripple-on effects as plants close their doors. Even as early as early February, many automotive manufacturers were extracting their foreign staff from the region.

             The importance of info materials being available in the right language

Dr Bruce Aylward, the Assistant Director-General of the World Health Organisation (WHO), stated in a recent interview that the vital question in coming months was going to be:

Are there any barriers to finding cases quickly, to getting them tested and getting them isolated?

He was referring specifically to how well countries who are currently (or soon will be) experiencing coronavirus outbreaks will be able to handle them.

Dr Aylward went on to say that those language barriers in healthcare can be as simple as:

  • “Are materials available in the right language?”
  • “Does the population know they’re looking for a fever and a cough? Not a cold. Not a runny nose.”
  • “Do they know how to get tested?”

He also reiterated the importance of following the official advice of organisations like the WHO, who have developed evidence-based strategies for best practice during this and many other types of health crisis.

             Coronavirus vaccine and the future

Marc Lipsitch, Professor of Epidemiology and Director of the Centre for Communicable Disease Dynamics at Harvard, has stated that somewhere in the region of 40-70% of the world’s adult population may be affected by the time the virus has run its course.

This does not mean they will have severe illnesses, of course. Some people may have it very mildly or even be entirely asymptomatic.

But still, that is a potentially huge proportion of the world’s population which may come to be infected. This makes immediate work towards a vaccine critical.

Luckily, genetic sequencing technology is now incredibly fast. However, making vaccines requires walking an almost impossibly-fine line between creating a protective immune-system memory and going too far and actually causing the symptoms of the virus themselves.

This will require extensive testing in models and animals before further testing in people. Again, being able to convey precise medical research data and information across language and cultural barriers will prove a vital resource in the months to come.