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Wearing masks at a train station in Wuhan, China, to ward off infection

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Are We Prepared for the Next Pandemic?

The rise of the coronavirus from China raises tough questions about the world’s readiness for a global outbreak

Last fall, a group created by the World Health Organization and the World Bank issued a report about whether governments are ready to cope with a new global pandemic. The blunt conclusion issued in the first paragraph of that report wasn’t reassuring: “The world is not prepared.”

There’s a very real threat of a rapidly spreading contagious disease killing 50 million to 80 million people and wiping out nearly 5 percent of the global economy, according to the report.

“The world has become much higher risk, and we need to change our thinking accordingly,” says Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies in Washington, D.C. “The velocity of these outbreaks are increasing because we have bigger populations and they’re moving around faster.”

Last fall, a group created by the World Health Organization and the World Bank issued a report about whether governments are ready to cope with a new global pandemic. The blunt conclusion issued in the first paragraph of that report wasn’t reassuring: “The world is not prepared.”

There’s a very real threat of a rapidly spreading contagious disease killing 50 million to 80 million people and wiping out nearly 5 percent of the global economy, according to the report.

“The world has become much higher risk, and we need to change our thinking accordingly,” says Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies in Washington, D.C. “The velocity of these outbreaks are increasing because we have bigger populations and they’re moving around faster.”

Jim McMahon

Those higher risks became painfully obvious in January when Chinese officials acknowledged the emergence of a new highly contagious coronavirus in Wuhan, China. The virus infected more than 60,000 people and killed more than 1,300 in the first two months, with the death toll rising fast. It also spread to dozens of countries and prompted the Chinese government to lock down more than 57 million people to prevent its spread. By the first week in March, there were about 100 confirmed cases of coronavirus in the United States and two people had died of it.

The Wuhan outbreak—likely originating from wildlife traded at a seafood market—had broad ripple effects. The World Health Organization declared a global emergency, though the number of coronavirus deaths initially paled compared to the more than 10,000 deaths from seasonal flu this winter in the U.S. alone. A number of international airlines suspended service to China. Foreign countries, including the U.S., sent chartered planes to rescue their citizens stuck in the quarantine zone. Many businesses shut down temporarily, and foreign companies that depend on materials from China had their supply chains interrupted. 

Those higher risks became painfully obvious in January with the emergence of a new highly contagious coronavirus in Wuhan, China. That virus infected more than 60,000 people and killed more than 1,300 in the first two months. It spread to dozens of countries. In response, the Chinese government locked down more than 57 million people to stop the spread of the virus. By the first week in March, there were about 100 confirmed cases of coronavirus in the United States and two people had died of it.

The Wuhan outbreak likely originated from wildlife traded at a seafood market. The number of coronavirus deaths initially seemed small compared to the more than 10,000 deaths from seasonal flu this winter in the U.S. alone. Still, it had broad ripple effects. The World Health Organization declared a global emergency. And many international airlines suspended service to China. Foreign countries, including the U.S., sent chartered planes to rescue their citizens stuck in the quarantine zone. Many businesses shut down temporarily. And foreign companies that depend on materials from China had their supply chains interrupted.

In Wuhan, hospitals were overwhelmed by thousands of people swarming emergency rooms. In their panic, many Chinese expressed their fears and frustration with the government on social media—rare under China’s authoritarian rule—posting videos showing chaos at local hospitals.

“It is very scary,” says Cai Pei of Wuhan, whose wife was sick with a cough and fever. She could have the coronavirus but was turned away from a hospital. “If it’s real, we have a child and elderly parents at home. What if we all get sick?”

There was a run on surgical masks, not only in China but also around the world, including in the U.S., amid fears of the virus’s spread. Masks are not always effective in preventing people from being infected, health officials say, but in a state of alarm, people do what they can.

In Wuhan, hospitals couldn’t handle the thousands of people flooding into emergency rooms. In their panic, many Chinese expressed their fears and frustration with the government on social media. They posted videos showing chaos at local hospitals. This type of social media activity is rare under China’s authoritarian rule.

“It is very scary,” says Cai Pei of Wuhan, whose wife was sick with a cough and fever. She could have the coronavirus but was turned away from a hospital. “If it’s real, we have a child and elderly parents at home. What if we all get sick?”

There was a run on surgical masks as fear grew of the virus spreading. These masks were in demand in China and around the world, including in the U.S. Health officials say that masks are not always effective in preventing people from being infected. But in a state of alarm, people do what they can.

A Connected World

The most famous global pandemic is probably the Spanish flu, which killed some 50 million people as it swept around the world in 1918 (see “Deadliest Pandemics,” below). It was an especially deadly strain of influenza that turned the skin blue, filled the victim’s lungs with a bloody froth, and could kill within hours. Unlike most flu strains, the 1918 virus killed many otherwise healthy young adults.

In a world with a wide variety of contagious threats, the emergence of a virus similar to the 1918 flu continues to worry many scientists. Part of what enabled that outbreak to have such a broad impact was the huge numbers of people who were moving around the globe in the aftermath of World War I, bringing the virus with them. Just imagine, experts say, how much faster a lethal virus could move in today’s world.

The most famous global pandemic is probably the Spanish flu. It killed some 50 million people as it swept around the world in 1918 (see “Deadliest Pandemics,” below). It was a very deadly strain of influenza that turned the skin blue and filled the victim’s lungs with a bloody froth. It could kill within hours. Unlike most flu strains, the 1918 virus killed many otherwise healthy young adults.

There’s a wide variety of contagious threats in the world today. That’s why the emergence of a virus similar to the 1918 flu continues to worry many scientists. Part of what enabled that outbreak to have such a broad impact was the huge number of people who were moving around the globe in the aftermath of World War I. They spread the virus wherever they went. Just imagine, experts say, how much faster a lethal virus could move in today’s world.

Hector Retamal/AFP via Getty Images

Medical staff in protective gear bring a patient to the hospital in Wuhan.

“Two hundred years ago, if I wanted to go to the other side of the world, I had to spend months on a boat,” says Arthur Reingold, an expert in infectious disease at the University of California, Berkeley. “Today I can be virtually anywhere in the world in 36 hours on a plane.”

Despite the increased risks, the world has many advantages it didn’t have in 1918: vaccines, antibiotics, sophisticated equipment for diagnosing illness, and a wide range of effective treatments, as well as experienced public health organizations to direct efforts.

“We’ve got a lot of tools that are constantly evolving, constantly improving,” Reingold says.

In the meantime, experts say the most effective thing countries can do is invest in public health systems so they’re better prepared when the next destructive virus comes along.

“We know with certainty that these types of outbreaks will continue to happen,” Reingold says. “So we need to be prepared.”

“Two hundred years ago, if I wanted to go to the other side of the world, I had to spend months on a boat,” says Arthur Reingold, an expert in infectious disease at the University of California, Berkeley. “Today I can be virtually anywhere in the world in 36 hours on a plane.”

Despite the increased risks, the world has many advantages it didn’t have in 1918. Vaccines, antibiotics, modern equipment for diagnosing illness, and a wide range of effective treatments now exist. There are also experienced public health organizations to direct efforts.

“We’ve got a lot of tools that are constantly evolving, constantly improving,” Reingold says.

In the meantime, experts say the best step countries can take is invest in public health systems. Doing so would help them be better prepared when the next destructive virus comes along.

“We know with certainty that these types of outbreaks will continue to happen,” Reingold says. “So we need to be prepared.”

With reporting by Sui-Lee Wee of The New York Times.

With reporting by Sui-Lee Wee of The New York Times.

DEADLIEST PANDEMICS

1. The Black Death

75-100 million dead (1346-53)

An outbreak of bubonic plague—a bacterial infection that’s deadly if not treated—devastates Europe, Africa, and Asia.

75-100 million dead (1346-53)

An outbreak of bubonic plague—a bacterial infection that’s deadly if not treated—devastates Europe, Africa, and Asia.

National Archives

An emergency hospital for flu patients, Brookline, Massachusetts, 1918

2. Spanish Flu

50 million dead (1918)

A powerful influenza virus spreads across the globe amid the chaos of World War I.

50 million dead (1918)

A powerful influenza virus spreads across the globe amid the chaos of World War I.

3. HIV/AIDS

32 million dead (1980s to present)

This virus, which strikes the immune system, can be transmitted only through bodily fluids. It can be effectively prevented and treated but not cured.

32 million dead (1980s to present)

This virus, which strikes the immune system, can be transmitted only through bodily fluids. It can be effectively prevented and treated but not cured.

4. Plague of Justinian

25 million dead (541-42 A.D.)

An outbreak of bubonic plague is believed to have killed half the population of Europe at the time.

25 million dead (541-42 A.D.)

An outbreak of bubonic plague is believed to have killed half the population of Europe at the time.

5. Antonine Plague

5 million dead (165 A.D.)

The cause of this outbreak across the Roman Empire is unknown but thought to be either measles or smallpox.

5 million dead (165 A.D.)

The cause of this outbreak across the Roman Empire is unknown but thought to be either measles or smallpox.

6. Asian Flu

2 million dead (1957-58)

This influenza outbreak began in China and spread to Singapore, Hong Kong, and the U.S.

2 million dead (1957-58)

This influenza outbreak began in China and spread to Singapore, Hong Kong, and the U.S.

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