Pandemic disease and terrorism have a strange commonality — the ability to make familiar spaces seem dangerous, and the ability to engender suspicion among people sharing those spaces. The latest pandemic — the 2019 novel coronavirus, COVID-19 for short — is no different.
I flew to London from New York two weeks ago, a trip I am accustomed to as an Englishman in New York. While the routine was familiar, the atmosphere was different. A handful of passengers wore masks, either for their own protection or everyone else’s, and each cough or sneeze in the cabin took on a magnified significance. Like terrorism, the fear of pandemics outweighs the actual risks. In the past 10 years, less than 0.1 percent of deaths in the U.S. were caused by terrorists or pandemic diseases. Yet more than half of Americans are worried about becoming a victim of terrorism, and in 2014 Americans ranked Ebola as the country’s third greatest health concern (above heart disease, cancer and diabetes, which combined causes 60 percent of deaths). Although the fear outweighs the impacts, I can’t help but wonder if it is one of the factors keeping death rates low — people report suspicious activity and take precautions because of their exaggerated fears. Citizens can’t be expected to behave rationally all the time, but the governments of world powers should be held to a different standard – the U.S. and China have failed to adequately prepare and respond to this predictable pandemic outbreak.
COVID-19 originated in the Chinese city of Wuhan, supposedly from a wild animal market — the textbook origin story for pandemic disease. Wuhan, like many Chinese cities, is densely populated and well-connected. Eleven million people reside there, with many more traveling through in a typical week. The week of the 20th of January was not a typical week; it was the week of the Lunar New Year, a time when many travel to spend time with their families or visit tourist attractions. Wuhan hosted a record-breaking banquet with 13,986 dishes, with tens of thousands of families involved in preparing and attending the feast. But rather than a celebration of community and opulence, it became an incubation chamber for the virus. Four weeks earlier, the first reports of a suspicious, pneumonia-causing virus had been received and buried by the city’s authorities. Finally, in the week of the 20th of January, the government admitted that COVID-19 was a serious public health risk.
Nothing about this pandemic will surprise the global health community. There is an inevitability to pandemics. Before coming to Yale, I was part of the United Nations’ Emerging Pandemic Threats team – a program funded by the U.S. government after the 2014 Ebola outbreak in West Africa, to develop worldwide surveillance for potential pandemic disease emergence – and coronaviruses were at the top of the list. Wild animals host a great variety of viruses, most of which are harmless, but these viruses are constantly mutating and mixing. Bats are considered the most likely source of pandemics because their biology and social behavior is ideally suited for incubating and breeding new viruses. Each evening they fly to far-flung places where they may pick up a new virus, then fly back to their colony and hang, in close proximity, with sometimes thousands of other bats. The family of parasitic fly Nycteribiidae is the only type of fly that has neither wings nor eyes — their bat hosts sleep so tightly packed the flies need neither organ to travel from host to host. This proximity allows viruses to spread easily too, and because their mammalian biology is so similar to ours, the diseases that effectively spread between them are more likely to spread between humans too. Because humans have little contact with bats, there is often an intermediate host — the MERS-CoV is passed on to humans by camels, SARS-CoV is transmitted via civets, and the latest evidence points to pangolins as the possible source of COVID-19. The great diversity and mutating nature of viruses in the wild make the emergence of pandemics inevitable. The trick is to be ready when they first transfer to humans so that they can be contained. Unfortunately, in 2019, the U.S. government failed to renew much of the funding allocated to emerging pandemic disease surveillance.
The Chinese have a penchant for exotic animal products, often used in traditional medicine, and live-animal markets, making China a likely source of pandemic disease outbreaks. High population density amplifies the risks of disease transition and China’s authoritarian government can hinder swift reporting and transparent information sharing, allowing the virus to spread uninhibited. In the case of SARS, the Chinese government covered up the pandemic’s existence for four months. COVID-19 was suppressed for less than two months before word got out. Once established in the population, extreme measures must be taken to control the spread of pandemic diseases, and as is always the case in medicine, prevention is better than cure. We can only hope that the containment efforts put in place are not too late to prevent this from becoming a global pandemic, and that the Chinese government will see the importance of sharing any information it has about the disease with their citizens and the global community. If they don’t, this is one pandemic that Americans should fear.
MATTHEW BURNETT is a second-year MA candidate at the Jackson Institute for Global Affairs. Contact him at matthew.burnett@yale.edu .