Pandemics and risk management
Pandemics have occurred several times throughout human history, and apparently, they seem to be increasing in frequency in recent times. The current outbreak of the novel coronavirus (COVID-19) has caused significant financial market, economic, social, and political disruption all around the globe.
As the world looks on carefully to take the best preventive measures to contain the spread of the disease, studies show that the coronavirus contagion rate makes it hard to control, and its severity, can intensify in the lack of preparedness.
Viruses know no boundaries, and every nation is at equal risk during pandemics. It requires coordinated efforts to mitigate the situation appropriately. But, the efforts toward achieving competitive International Health Regulations (IHR) worldwide have been relatively uneven. Significant gaps exist in the global pandemic preparedness. In this context, there is a dire need for substantial policy attention worldwide to identify and limit the adverse impacts of infectious diseases.
The international community looks busy in continually building and implementing action plans towards mitigating the impacts of the pandemic. Countries are taking strict approaches, including business shut-downs, travel restrictions, and even nationwide lockdowns to control the risks. The Nepal government has also joined the global effort to stem the spread of the coronavirus as it has decided to impose a nationwide lockdown to promote social distancing. Taking even sterner measures to mitigate the ongoing threat, the government has also decided to cancel all international flights as a precautionary measure to keep the nation away from contagion.
As Nepal fights the coronavirus scare, our fundamental bureaucratic and public management capabilities and our overall competency are subjected to testing. Nepal lacks cash flow and the financial resources to pay for disease response and weather the economic shock of the outbreak. In the current scenario, the subject of public health is of primary concern, but an economic downturn is also inevitable. We must be prepared for the worst.
Pandemic risk is driven by the combined effects of spark risk (how or where it is likely to arise) and spread risk (how likely it is to diffuse across borders). There can be several plausible factors that can spark a pandemic; mostly, they are pathogens. After a spark, the risk that a pathogen will spread within a population is influenced by factors such as population density, travel, trade, and speed and effectiveness of public health surveillance and response measures. If we can limit the causes of the spread, we can considerably reduce their impacts.
The direct health impacts of pandemics can be catastrophic. The existing health facilities in Nepal are inadequate to carry out testing and provide isolation to everyone in need. During pandemics, regular health care gets disrupted due to the overflow of infected patients, resulting in the lack of routine care for other diseases.
Indirect deaths due to overwhelmed hospitals had led to an estimated 10,600 additional deaths in Guinea, Liberia and Sierra Leone during the Ebola outbreak in 2014, which was nearly equal to the deaths directly caused by the Ebola in those countries.
During a severe pandemic, all sectors of the economy—agriculture, industry, services—face disruption, potentially leading to shortages, anomalous price increase, and economic constraints for common households, private firms, and governments. Pandemics outbreak can inflict severe disruption in the financial market, including short-term fiscal shocks and long-term adverse shocks to economic growth.
Larger outbreaks of infectious disease can have direct and consequential social impacts. The 1994 outbreak of pneumonic plague in Surat, India, caused only a small number of reported cases, but fear led some 200,000 people to flee their homes. Sudden population shifts have destabilising effects and can elevate the risk on public health. Migration also creates the risk of further spreading an outbreak.
Despite high exposure to the spread risk, Nepal claims to have very few positive cases for the coronavirus to date. It is a good sign if there are no actual cases in Nepal, but poor testing rate may have masked the exact number of cases. If the government data is misrepresenting the real situation, undetected communal spread can make the situation even worse for us in the coming days. Situational awareness is a crucial activity in all stages of a pandemic and providing information that people can use to take protective and preventive actions will build the faith of the population in their health care system.
Investing in strengthening the core public health infrastructure, increasing situational awareness and rapidly extinguishing sparks are the most cost-effective measures in the pandemic preparedness, especially in resource-constrained settings like ours. Our public health efforts should focus on mapping out plans to contain the spread effectively. The government should implement a coordinated response focusing on the maintenance of situational awareness, public health messaging, reduction of transmission, and treatment of the ill.
Robust contingency planning and response require a massive surge capacity—the ability to manage a sudden influx of patients. We should swiftly carry out action plans to identify, trace and manage the cases by isolating the infected people and providing them with appropriate medical care. Converting large hotels into quarantine camps and making use of public buildings and open spaces can be our other possibilities on top of our currently available isolation facilities in case of an unanticipated rate of infection.
Effective risk communications can play an essential role in controlling an emerging pandemic. It lays out clear, simple and timely updates to the people. Celebrities can be credible messengers in social causes as the people will mindlessly prioritise the message of public figures over that of experts, professors and doctors. Ineffective risk communications, on the other hand, can spread misinformation and cause panic, anxiety and other psychological distress among the public. Therefore, it is the responsibility of public health officials to identify and address such rumours with evidence and clarity.
The health crisis has largely hit the global economy, and the wave of its impacts can hit harder on poor and developing countries. Considerable targeted policies are required to limit the economic fallout and market disruption. The practice of social distancing due to the coronavirus has substantially reduced economic activities, largely affecting the aviation, tourism and hospitality industry. The policymakers should implement effective fiscal, monetary and financial market measures to help the affected households and businesses. The government’s role in the time of this temporary crisis is to prevent people and businesses from permanent economic harm by saving them from job losses and bankruptcies.
Katuwal is a student at University of Louisiana Monroe