One Healthy World

At the dawn of the month of March 2020 the world witness with apprehension another zoonotic pandemic with unknown extension and damage prospects. With its epicenter at the “Wet Floor Market” in Wuhan and the first cases popping up right at the beginning of the longest holiday period in China, the Lunar New Year, its shockwave quickly spread out, first throughout China and then to the world. Although its real impact is yet to be shown and still to be measured in terms of life and economic losses, this new epidemic soon turned into pandemic has been causing an immense disruption in both China’s domestic economy and international supply chains. As consequence, world Stocks Exchanges plummeted in its worse fall since the Great Crisis of 2008, -11%. To put this into perspective, the Brazilian GDP, the 9th economy of the world, has simply vanished from the business pipeline, an estimated US$ 2 trillion Dollars (so far) had been wiped out from the table in just 7 day. Countries’ GDPs are being revised for the low and the World Economy tingle with the the barrier of +2,50% world GDP growth, which is an indicative of a world economic recession as its below population growth. As a result of the Sars-CoV-2, China’s first quarter economic growth is expected to slip to about three percent or lower, down from six percent in the previous quarter, which would be the weakest result in nearly 30 years. The Chinese government has already informed they will release special funds to mitigate the situation and invest in companies that would come with solutions and Central Banks around the world are called in to do what they do with the weapons they have: inject more money and decrease interest rates in an overloaded world economy with unforeseen results. These means will never meet its ends.

So, as we write this paper at the weird man-made day of 29th February 2020, this new coronavirus (Sars-CoV-2), is a newcomer at the now seven strains known to infect humans causing illnesses in the respiratory tract. Four of those strains cause common colds. Two others, by contrast, rank among the deadliest of human infections: SARS, and MERS. Now this This Sars-CoV-2 that has, to date, infected more than 85,000 people in the world, with almost 40.000 cases clinically closed and a mortality rate of around 7% among those clinically closed ones, figure which is much higher than the 3% that has been ventilated in the last days, which is based on . If these same figures are taken as guidance for the still opened cases (not clinically closed), and if it is also taken into consideration that the virus head towards countries with less physical and financial resources, where societies are less behaviorally cohesive as the Chinese one, where it is not possible to build up a 1600-bed hospital in a whopping 10 days, where statistics are less reliable and medicine isless prepared to face the outbreak than in China or in the USA, we might be facing something that might run wild for a period longer than expected. This is a scenario, maybe one of the worse ones but factible one (nao quero levar ninguem à conclusoes precipitadas).

The purpose of this paper is not only to revise the interaction between the Sars-Cov-2 and the economy but also look ahead beyond this current crisis (that should be tackled with the available resources), and raise the following question: knowing the likelihood of a next outburst, knowing that a next zoonotic pathogenic pandemic might cost something between 2 and 4 Trillion Dollars (say this would be the world’s budget to prevent a next outburst), what should have been done to start implementing a Global Response to Zoonotic Pathogenic Pandemics as quick as possible? Why not change the response, and instead of drowning the economy with more money aimed the end of the pipeline, why not invest on creating systems and mechanisms to prevent and avoid zoonotic pandemic diseases as much as we can? This question came to my mind when I started to investigate the sanitary system in China for investments reasons, and realized that China’s The National Medical Products Administration mandate has a lesser prominent role preventive actions on food security than their counterparts as the FDA in the USA, and the INMETRO/ANVISA/MAPA in Brazil, and the lack of preventive and controlling measures of veterinary sanity and safety. And China has a two-prong challenge: China must do its homework on banning sales and consumption of wildlife, which goes towards a profound social change in eating behavior while creating a new integrated system to control food origin and zoonoses, something normally very difficult to achieve but possible in a society such as the Chinese one (for more information see Hofstede’s dimensions). All of this link to the propose and purpose of the One Health concept as an integrated action framework between mankind and wildlife upon which a new system can be deployed in order to better prevent the next virus outbreak and avoid trillionaire losses in US Dollars. Understanding the cycle of this virus, its particularities and how it can disrupt the world economy now if not contained and in the future, in is key to forecast the scenarios and risks brought by this new outbreak and, what’s most important: what to do now in order to avoid the next one.

 

Looking the past: other zoonotic pathogenic pandemics

Viruses are fascinating creatures. At the edge of the reign of the living and the non-living, these creatures adapts to the environment in search of its continuous objective: to replicate and spread continuously and in the most efficient way. As we do, “learn & perfect”, in its way they do the same. And we are their cute hosts: warm and liquid, capable of travel long distances carrying our unlikely guests and meeting other living creatures the same species in an ever increasing offer of bodies to harbor them: we are 7.7 billion on our way to become 10 billion human beings in this planet, a big herd. But In this process of “learn & perfect” viruses made some blows, reason why the most virulent ones, the ones with short incubation period and acute and deadly symptoms such as Ebola, Hanta, Marbourg or even the H5N1, are not the most prone to pandemics as they kill the host too quickly to be spread around. More deceptive viruses, thus more spreadable viruses, are the ones with longer incubation period and that debilitate the host only when its viral load is too high to be supported by the host’s immune system and other opportunistic pathogens make their way. If this was a battle strategy (or indeed it this is the most efficient one: “spread before attacking”. Bringing to a more factible example, these tactics and strategies can be seen being replicated even with digital viruses: there is an efficiency curve, but the longer a virus travels without being noticed the higher is its replication, maximizing its objective and, intentionally or not, damaging or disrupting the individual (computer) and the ecosystem (network) where it operates when it’s cycle is over. So, from the virus perspective the best of the worlds would be a very contagious strain with long time span to show symptoms, allowing the host to be in contact with as many others individuals from the same species as possible, with low host’s mortality rate and the possibility of reinfection.

Differently of what happened during the SARS epidemic (another zoonosis) in 2003 in China as well, it seems that this time the Chinese government has done a proper job of restraining circulation and confining people, imposing a 14-day quarantine (this info is going to be used later on here) for the ones transiting between hot and cold areas, shutting down roads and railroads, restricting flights, warning people to avoid agglomerations. However, unlike the Sars-CoV-2, as some disease modeling and case studies suggest, that spreads fast and is highly transmittable, the SARS had its spreading range hindered by the promptness of how symptoms appeared to the ones carrying the virus: between 3 to 5 days the infected switched from asymptomatic to symptomatic. The Sars-CoV-2 has a different process and hosts remain asymptomatic for much longer, reportedly between 10 to 14 days, but a good part of them (an estimated of 20%) transmits the virus even while asymptomatic. And with the changes in the world from 2003 to 2020 (demographics, lifestyle, urbanization, cross-continental travels, etc.) pandemics are, until further notice, each day easier to happen.

What we already know about the nCoV-19

  • incubates for up 14 days (against SARS 3 to 5 days, for example), hosts might be transmitting while asymptomatic
  • Quickly spreads and easily transmitted (it took eight months for the SARS to infect the same amount of people the Sars-CoV-2 already infected in just three weeks)
  • Its gravity is worse than normal flu (contrary to what’s been broadcast)
  • Does not prefer cold but cold conditions weakens people’s immune system
  • Low to moderate mortality rate
  • Large agglomerations facilitate its widespread

 

What’s yet to be confirmed

  • Can reinfect (this would be a novelty in the virus realm unless a virus suffers a mutation – like the Dengue Fever A, B and C strains)
  • Mortality rate in other countries as the disease spreads to Southern Hemisphere countries (although its economic relevance would be less important to the world economy)

 

Nobody wants to be part of the 3%

Human beings are a very intelligent species, its brain was geared to make calculations automatically and this is what differentiate us from other species. Our brain, optical and somatic nervous system have developed into a very efficient hunting machine: we can calculate trajectories and kinetics, if you throw a ball towards a dog he will deviate; if you throw a ball towards a human being he will judge its risk and will deviate or catch it, a much more complex, refined and coordinated movements. We calculate everything. We rank, assign, judge, compare and classify automatically. So, for anyone exposed to the possibility of being contaminated by and, unfortunately, become part of the 3 or 7% the calculation for this epidemic is very simple: avoid risks, avoid situations where an individual can be potentially exposed to the virus which can be transmitted by someone who’s still asymptomatic. So, would you come back to work at your office on Monday if you know there was someone who’s been shown symptoms only during this weekend, which means this person would be infected – and possibly transmitting – in the last 10 to 14 days? And within the time span of 14 days how many people had been infected and how long it would take for them so have the virus confirmed? And for the ones with contact with contaminated individuals, how long would that take to show symptoms? 14 days is a long time for counting who has Cov-19 (the disease) and who hasn’t and for the ones still not infected in the middle of infected ones the subjacent question would be: should I take the risk of going back to my everyday activities and return to school, office, factory? Or should I self-impose a quarantine until this wave passes away? And for the ones who don’t have this choice what to do? N-95 masks (already in shortage in the market), alcohol and pray? And as the Sars-Cov-19 reaches more countries in the Southern Hemisphere, where the expected mortality rate could be high the impact in the world economy would be low, as the Southern Hemisphere countries – excluding China – respond for only 27% of the Total GPD of the world (confirmar dado na database IMF).

But, being anywhere in the world, nobody wants to be at the wrong side of the distribution curve, nobody wants to be at the 3%. Or 7%.

 

Conclusion:

At the moment the Chinese government starts to lift some of the very restrictive circulation procedures they had to put in place more than 30 days ago in order to contain the highly transmissible virus spread. Now some shops and markets were allowed to open in an attempt to engaje business and make life looks normal again, after families mourned their losses, schools been interrupted, social tensions due to uncertainty and businesses been deprived from revenue for such a long time, impacting whole supply chains in China and worldwide. And after those last weeks following the subject, the last readings are that the virus is highly transmittable but has a relative low rate of mortality, which gives a first sign of relief that “it might not be as bad as it seems”. Yes, from the mortality rate perspective it seems – luckily – that this is not “as bad as it seems” although we shall watch how it spreads. It must always be taken into consideration that the product of a high infectious rate times low mortality rate is something different, in absolute terms, if we speak about 100.000 people or if we speak about 4 million people. Reason why this epidemic is so disruptive: in order to tame the infectious rate either a vaccine or a halt of human physical contact is necessary. Both cost money, time and lives.

In a world which depends of movement to create value, countries and economies slowly bog on the empty supply chains, arms don’t reach markets anymore. And while the world briefly breath – as if it would be possible – that the mortality rate of this nCorV-19 seems below SARS’ but well above any other influenza virus it is time for the countries – starting with China for several reasons – to start looking at this subject from another perspective. Through discipline and seriousness China can be capable of showing a fascinating way of promoting deep cultural changes in food habits would be and create a proper sanitary vigilance system based on One Health principles that would be of great benefit for the whole Mankind. The great advantage is that China has been showing in the last 20 years that they are capable of great feats and this will be another showcase for the whole world.

This is my thesis, what’s yours?

Good luck for us all.