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Week 11
Pandemics in Asia - Coggle Diagram
Week 11
Pandemics in Asia
Pandemics
definition: 'an epidemic occurring world wide, or over a very wide area, crossing international boundaries and usually affecting a large number of people'
- seasonal epidemics are not considered pandemics
What makes pandemics possible?
- Population explosion and changing urban landscapes
- unprecedented shift in human population and the intense process of urbanisation is one reason why more disease originates in Asia and Africa
- the world bank reported that during the first decade of the 21st century, almost 200 million people moved to urban areas in East Asia
- migration on that scale means that forest land is destroyed to create residential areas
- wild animals forced to move closer to cities and towns inevitably encounter domestic animals and the human population
- wild animals often harbour viruses e.g. bats - covid can carry hundreds of virus
- extreme urbanisation becomes a vicious cycle, more people bring more deforestation and human expansion and the loss of habitat ultimately kills off predators including those that feed off rodents
- with the predators gone, or at least with their numbers sharply diminished, the rodent population explodes and so does the risk of zoonotic disease
- Human interaction with non-human species
- human interaction in non human species has increased dur to environmental degradation caused by urbanisation and modern consumption
- farming systems throughout Africa and Asia don't help
- on both continents, many families depend on subsistence farming and a minuscule supply of livestock
- disease control, feed supplementation and housing for those animals is extremely limited
- Cattle, chickens and pigs which can carry endemic disease are often in close contact with each other - a variety of non domestic animals and humans to
- live animal markets are also a problem
- In china there is a huge market for Chinese medicine which claims to provide remedies for a host of conditions like arthritis, epilepsy and erectile dysfunction
- coronaviruses are a large family of viruses common in animals common in camels and bats
- most human coronaviruses typically cause mild to moderate illness but some can become more severe
-SARS is a viral respiratory illness caused by a coronavirus
- SARS was first reported in February 2003
- was called the first pandemic of the 21st century
- highly infectious - quickly spread to 37 countries, infecting over 8000 people and killing 813, with over 600 of these deaths in mainland China and Hong Kong
- spread around the world
- China introduced new infectious disease controls
- Ebola
- strain in 2019 in Yunnan and China found in bats
- even though Asia was not as affected by Ebola, it was a lesson for them
- deadly and killed : up to 50% of those who got sick
- towards the end of the virus it only became transmissible through bodily fluids e.g blood and sweat therefore wasn't as contagious as coronavirus
MERS = middle east respiratory syndrome
- caused by a novel coronavirus
- 2012 bats in Saudi Arabia
- symptoms include fever, cough and shortness of breath often leading to pneumonia
- 4th May 2015, 68 year old Korean man returned from travel in the Middle East - led to a large outbreak
- MERS led countries around the world to step up screening and activate thermal scanners for incoming passengers from South Korea
- economical and political impact on South Korea
- took a single case to start an outbreak
- globalisation of travel means globalisation of disease
- hospitals can amplify outbreaks
- to prevent further spread, effective and rapid coordinated approaches are needed
Swine flu
- 2009 epidemic
- 18,000 registered deaths but estimates of up to 575000 deaths in Southeast Asia and Africa where access to treatment and prevention resources was limited
H5N1 avian influenza
- infected 18 people
- 6 died
- over 1.5 million chickens slaughtered in Hong Kong to halt spread
- symptoms included pneumonia like conditions and multiple organ failure
- 3 outbreaks within the next year but the H5N1 virus has not resurfaced in Hong Kong although there are still isolated cases worldwide
- many of the viruses that have affected us over the past 20 years have emerged from non-human reservoirs
- can be located in animal populations
- bats have been shown to be the natural reservoir of numerous deadly human viruses
- specialised immune systems of bats allow multiple viruses to persist
- we continue to make stronger the conditions in which zoonotic diseases thrive
7 main drivers of pandemics
- The increasing demand for animal protein as newly event advancing economies in places like Southeast Asia rapidly increase the consumption of meat
- Unsustainable agricultural intensification resulting from that increasing demand for animal source feeds
- intensification of agriculture and in particular of domestic livestock farming results in large numbers of genetically similar animals
- these are often being kept in close proximity to each other and often in less than ideal conditions
- genetically homogenous host populations are more vulnerable to infection than genetically diverse populations because the latter are more likely to include some individuals that better resist disease
- factory farming of pigs promoted the transmission of swine flu due to a lack of physical distancing between the animals
- Increased use and exploitation of wildfire has been seen
- can lead to increased close contact between animals and peoples throughout the supply chain
- increases the risk of zoonotic viruses spreading
- Unsustainable utilisation of natural resources accelerated by urbanisation, land use, change and extractive industries
- often this causes novel and diverse contacts amongst wildfire, livestock and people, creating favourable grounds for the emergence of infection
- travel and transportation enable diseases to move around the world
- food supply chains are lengthening and diversifying especially in low and multiple income countries
- Climate change has an impact as many zoonoses are climate sensitive and a number of them will thrive in a warmer, wetter more disaster prone world
COVID-19 in Asia
- began in a market in Wuhan in China linked to bats
- was not a wildlife market but a wet market
Wet market
- different from wildlife market
- live animal markets:
- crowded conditions and multiple species including humans
- confined spaced, stress, exchange of multiple different bodily fluids
- blood water and ice on the floor
- human handling of animals leads to spread to human population
- further facilitated by long working hours and stress of the handlers themselves as well as cuts, scratches, bites or other wounds
Lessons from SARS
- in the case of SARS, China was ill-prepared
- afterwards, it set up national disease surveillance network and invested in research into coronaviruses
- December 2019 Chinese scientists could identify and share genome sequences for covid-19
Chinese Politics
- top down nature of the Chinese state
- decisive lockdown quick and controllable
- Chinese national health commission sent 3 groups of infectious disease experts to Wuhan at the start of the outbreak - influenced decision to lock down Wuhan
- Control measures made possible by this top-regime, bolstered by culture of compliance and mask wearing
- China's 'community solidarity'
PLA (People's Liberation Army)
China's people's liberation army (PLA):
- efforts to combine military and civilian technologies are longstanding in China but they have become more pronounced under President Xi Jinping
- he has driven a campaign of 'military-civil fussion' and coronavirus has become an accelerant
- forefront of developing areas of medical research with possible military application such as biological weapons and contagious diseases
- PLA's own research institutes have not only played important roles in developing vaccines, alongside private companies but mass testing has also been done on PLA staff
Criticisms
- lack of transparency from Chinese state
- centralised nature of Chinese polity meant Wuhan and Beijing authorities minimised concerns expressed by local doctors in Wuhan
- they initially argued that there was no evidence that the virus was transmitted by humans
- censors were tasked with deleting evidence and rewriting the story of COVID
- the authorities instead spread the story of a controlled and top-down closure of Wuhan on 23rd January admist tough control measures
- for the 5 weeks prior to lockdown in Wuhan about 5 million people left the city for destinations in China and around the world