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| U.S. CDC confirms first 'unknown origin' coronavirus case in northern California resident who hasn't recently traveled abroad or been exposed to an infected patient.Trump announced Vice-President Mike Pence will be in charge of the nation's response to the disease in a press conference on Feb 26. |
Just as the COVID-2019 epidemic appears to be under control in China, serious new outbreaks have occurred in South Korea, Italy, Japan, Iran and elsewhere. The virus seems to be ubiquitous and unstoppable. While I am hopeful that the epidemic in China will be over by the end of March, I worry about the possibility of overseas visitors to China bringing the coronavirus back and starting a fresh epidemic again. China cannot afford to have its hard-won and costly victory over the virus annulled by a few infected visitors from abroad.
What China can and should do is to maintain the strictest quarantine measures for all entrants into the country, including its own nationals, who are either from or have been in or through seriously infected areas in the previous 14 days. They should all be required to undergo quarantine in government-furnished isolation facilities.
To facilitate such a requirement, Chinese airports and ports of entry should be limited to Beijing, Shanghai, Tianjin, Guangzhou and Shenzhen, with ready isolation facilities nearby.
This measure may sound draconian, and it would disrupt not only tourism but all commercial activity, including international trade and cross-border investment between China and other countries. But this is the only safe and sure way to prevent a recurrence of a COVID-19 epidemic in China. China will switch from being a blocked country to a blocking country. Moreover, it is uncertain how long this situation will last. That depends on how quickly other countries can succeed in their own control efforts.
While it is true that China should and could have acted more quickly to close off Hubei province and Wuhan and implement a full lockdown, the stringent measures when applied were instrumental in confining the virus mostly to Hubei and, within Hubei, to Wuhan. They enabled China to keep the epidemic under control.
It is not clear whether other countries have the administrative ability or the social discipline to do the same.
Moreover, there is now some question whether Wuhan was the primary originating source of the coronavirus, since Patient Zero in Italy, as well as a Japanese case, did not have any direct or indirect connection with China. They shared a common history of having vacationed in Hawaii. A recently identified case in Northern California also had no connection with China. So it is at least possible that the primary originating source of the virus was somewhere else. Further testing and retesting of U.S. cases that occurred over the past six months, especially those that resulted in deaths, may throw some light on this question.
One might ask: If every country adopts a stringent entry policy for the protection of its citizens, does it mean the end of globalization? I believe this is not the end, but the beginning of a safer and more stable form of globalization that is less susceptible to disruption.
I recall that years ago I would travel not only with a passport but also with a small yellow booklet that contained a record of all my vaccinations and inoculations. It would always be examined upon my entry into another country. I would need vaccinations against smallpox, cholera and other diseases, and occasionally a shot of gamma globulin. What this epidemic has taught us is the necessity of reinstating some form of such requirements if we are to continue to be able to travel freely internationally.
The destination country of a traveler should know a person's recent health status, as well as his or her health and travel history, including vaccinations and possibly ad hoc antigen-specific tests. It would actually be quite straightforward for an international authority such as the World Health Organization to maintain such records in digital form and in real time, so that it they would be readily available for inspection whenever a traveler crosses a border.
For example, if and when a vaccine is available for COVID-19, it should be required for those who wish to be exempted from the mandatory quarantine requirement. This would also apply to other transmissible diseases and viruses in the future. A traveler without an acceptable WHO record would have to satisfy whatever other requirements the destination country may impose, including a lengthy quarantine period. If such a system were implemented globally, then citizens of all countries would be reassured that foreign visitors will not pose a threat to their health.
However, simply controlling the borders is not enough. It is extremely important to prevent domestic transmission of diseases and viruses by unidentified domestic infected patients; otherwise, the number of new domestic infected patients will rise as before. The transmission of the new coronavirus, like the SARS virus and the more common influenza virus, is almost entirely through direct or indirect physical contact between an infected patient and a healthy person, generally through the medium of a body fluid. Thus, the domestic population should be educated to take proper precautions against having either direct or indirect physical contact with any other person, friend or stranger.
This means adopting and maintaining good hygienic behavior. For example, one should forego shaking hands, kissing and hugging. One should wear face masks, wash hands regularly and refrain from touching one's eyes, nose and mouth with one's hands. In time, perhaps most doors can be sensor-operated and elevators can be voice-activated, so that even indirect physical contact can be minimized. The transmission of a disease or virus will stop if everyone takes full precautions for his or her own self-protection.
An epidemic such as the COVID-19 pneumonia, with its potential for disrupting or even halting all economic activity for months, provides yet another important justification for having reliable parallel sources for all critical supply chains. The China-U.S. trade war and the continuing technology rivalry between the two countries have already threatened to decouple established technology supply chains. But even without them, the epidemic shows that secondary sources remain indispensable. It is crucial for the world to have at least a second source for any link in any supply chain.
Doing so might be costly, but it would provide insurance against unexpected contingencies, such as an epidemic, a natural disaster or even a war. It would also prevent a supplier from exploiting its monopoly position to gouge customers. Not having backups for crucial supply chains may prove to be even more costly than having them, as production may be halted for the lack of a critical component supplied by a single vendor.
The trade war and the epidemic together will cause nations to reconsider the benefits and costs of unfettered globalization. If a country depends solely on the Middle East for its oil, it will be in serious trouble, even with a substantial oil inventory in reserve, when war breaks out in the Middle East. Of course, a country can try to be self-sufficient, as the former Soviet Union and China did at one time, but this is also extremely costly.
What we should expect to see in the future is “diversified globalization,” under which no one country would be totally dependent on another as its sole source of supply of a critical resource, component or part. There will have to be a second source for everything. In the long run, the world will be better off having two or more competing suppliers for every good or service.
