A woman wears a mask at a subway station in Shanghai. Photo: Reuters
The coronavirus that emerged late last year in central China has taken a terrible toll of human lives, but as efforts to contain it gather momentum, attention is turning to the health of the Chinese, Asian and global economies. How sick are they and how long might a full recovery take?
As of last Friday there were nearly 65,000 confirmed cases of illness from the virus, now officially known as Covid-19, in China and 27 other countries including Thailand. It is not yet clear whether the infection rate is slowing down, as China just last week changed its reporting criteria, resulting in a spike in the numbers.
News of viral infections and deaths has been spreading since mid-January, sowing panic across the globe and leading the World Health Organization (WHO) to declare a global health emergency. Nervous consumers are queuing to buy face masks and hand sanitiser, and thinking twice whenever they go out in public.
Concern about the spread of the virus has led to massive cuts in air travel, especially to and from China, and cancellations of major public events. Among the highest-profile casualties last week was the Mobile World Congress, which normally attracts 100,000 people to Barcelona for one of the tech world’s grandest gatherings.
Reports of quarantined cruise ships — including one that spent days cruising aimlessly around the Gulf of Thailand before being allowed into Cambodia — further illustrate the high degree of anxiety.
Against this backdrop, economists are trying to gauge the impact the sharp contraction in activity in China will ultimately have. The Chinese economy, which grew by a disappointing 6.1% last year, could slow to 4.5% growth in the first quarter, according to a Reuters poll, and 5% for the full year.
The concern is acute in Southeast Asia, where many economies are heavily interconnected with the world’s second largest economy. Export and import activity and tourism are the areas being hit the hardest.
Piti Srisangnam, an economics professor at Chulalongkorn University, said the ripple effects are being felt throughout global supply chains.
For example, Hyundai had to suspend production for several days this month at its Ulsan complex in South Korea, which has an annual capacity of 1.4 million vehicles, because it had run out of parts made by suppliers in Wuhan, the epicentre of the outbreak. Nissan had to close a plant in Japan for two days for the same reason.
Some factories in China that normally would have reopened on Feb 3 after the week-long Lunar New Year holiday remained closed to ensure the safety of workers, and are only expected to resume production this week.
“The global economy will experience shrinkage in the wake of the outbreak because the slowdown will occur worldwide,” said Mr Piti. “Also, China has many megaprojects that contribute to the world economy. Now, due to the virus, the momentum will slow down.
“Factory closures in China will disrupt supply chains that are dependent on orders from those factories. Whoever depends on China, they will experience a shortage of supply.”
TRAVEL TUMBLES
The prospects for the global travel industry, he noted, were already dim prior to the outbreak as economic conditions overall were weak. That was partly the legacy of the trade war between the United States and China, who have now reached a truce of sorts.
Mr Piti said the fallout from Covid-19 would be profound in the travel and tourism industry and on private consumption in Asia and around the world.
The airline industry is already bracing for loses of up to US$5 billion this year, the International Civil Aviation Organization (ICAO) said last week. It said 70 airlines had cancelled all international flights in and out of China and 50 others had reduced operations since the virus first emerged.
Moody’s Investors Service notes that the outbreak occurred at a time when passenger growth was already slowing in Asia Pacific, excluding Malaysia, as a result of softening economic conditions. A greater concentration of Chinese travellers in Asia Pacific has rendered airports in the region, and the companies that operate them such as the highly profitable Airports of Thailand Plc, more vulnerable.
In Southeast Asia, the number of travellers from China and other regional countries, the main drivers of the tourism industry, has been dwindling fast.
“The virus impacts the tourism sector immensely, especially in Thailand where half a million Chinese tourists visit monthly. This month and next month that number will dwindle profoundly, maybe down to zero,” the professor said, noting that everyone will take a hit, from airlines and hotel chains to restaurants, ground transport services, retailers, guides and souvenir shops.
Nearly 11 million Chinese holidaymakers — about 40% of them on group tours, which China banned on Jan 27 — spent some 570 billion baht in Thailand last year, more than a quarter of all foreign tourism receipts. The tourism industry as a whole contributes 21% directly and indirectly to the country’s gross domestic product, according to the World Travel & Tourism Council.
The Tourism Authority of Thailand is now resigned to a drop of at least 2 million Chinese arrivals this year, while overall arrivals could fall by 5 million from 39.8 million in 2019.
The Tourism and Sports Ministry has estimated that reduced travel from China alone could result in 50 billion baht in lost tourism revenue.
Not only does fear of getting sick deter international travellers, local people are also avoiding going out to public places, which will hurt the economy further.
Mr Piti recommends that governments in affected countries adopt stimulus measures to cope with the situation, such as incentives that encourage businesses to offer discounts and promotions to win visitors back.
Agriculture is another sector facing trouble, as if reduced harvests of key commodities because of drought conditions was not bad enough. In the short term, though, there could be an oversupply of products that normally would be shipped from Thailand to China, and ways need to be found to cope with this reality, he said.
To help alleviate the impact, Mr Piti said he would like to see broader-based stimulus policies that could generate shared benefits for the world economy. This is no time for trade protectionism, he added.
In any case, he predicts that the situation will be improve in the coming months. And while it is hard to give a timeline, the world economy will likely take a severe blow in the first quarter while a recovery will start to occur in the third.
During the Severe Acute Respiratory Syndrome (Sars) outbreak in 2002-03, the Chinese economy slowed sharply in the first quarter of 2003 but growth returned to normal by the third quarter. Commentators note, however, that China’s economy today is much larger and more closely interlinked with the economies of countries all over the world. As well, the scale of the Covid-19 outbreak has grown beyond that of Sars, although the response of Chinese and global health authorities has been much better.
SHORT-TERM PAIN
While policymakers and planners worry about the macroeconomic impact of the virus, the outlook on the ground is grim, especially in Thai destinations such as Bangkok, Chiang Mai and Phuket, which normally are thronged with Chinese visitors at this time of year.
“From my estimation based on revenue, the number of tourists, not just Chinese, has dropped by 30-40%,” said Namfon Nooplod, a 29-year-old restaurant owner in Phuket. Thankfully, she said, there are still some tourists from other countries.
Ms Namfon’s seafood restaurant is one of the most popular spots on Karon Beach, where travellers usually stroll on the long Beachwalk filled with dining, shopping and nightlife spots.
“My restaurant is located on the main street; it usually has more tourists,” she said last week. “We are open from 10 am to 1 am and it is usually crowded all day long.”
Even though tourists are still frequenting her restaurant, none spend like the Chinese, she said.
“Chinese tourists usually come in groups, and when it comes to food, they have no limit — a group of Chinese tourists would order eight thousand to twenty thousand baht worth of food and drinks per table.”
Meanwhile, bookings in restaurants and hotels are being cancelled and people are scared to go out, Ms Namfon observed. Even though businesses located on main streets are able to carry on, in other streets, shops and restaurants do not fare well due to the lack of pedestrians.
“I want to encourage people to travel,” she said. “The virus is not worrisome”.
PREVENTIVE MEASURES
Meanwhile, health professionals from around the world are continuing their efforts to slow the spread of Covid-19, while researchers try to come up with treatments that could still be months away.
Dr Daniel Kertesz, the WHO representative in Thailand, told a recent conference that the priority for member states right now is “limiting human-to-human transmission”.
The work includes identifying cases, isolating them so that they will not infect others, and tracing their contacts. “The second thing is really about addressing the crucial unknowns,” he added.
Dr Kertesz emphasised the importance of global sharing of information and data that allows the international community to get a better sense of questions that haven’t yet been answered.
Discussing whether it is necessary for countries to impose travel bans on Chinese visitors, Dr Kertesz said the WHO understands that different countries’ decisions were made based on their national considerations, but the organisation does not suggest the international community employ such an approach.
“Our experience is that they (travel bans) are not particularly effective,” he said.
He explained that a travel ban merely contributes to deferring the expansion of the infection, and it also creates difficulties for the international community to provide technical support to infected areas.
In Thailand, where 33 cases have been reported to date, the government and public health professionals are confident they can deal with whatever arises. That helps to explain why the country has not imposed a ban on Chinese visitors.
The Global Health Security Index (GHS Index), created by Johns Hopkins University, ranks Thailand sixth in the world, notes Dr Thanarak Plipat, deputy director of the Bureau of Epidemiology in the Department of Disease Control at the Ministry of Public Health.
The survey of 195 countries examines their capabilities of handling infectious disease in areas ranging from prevention, detection, reporting and rapid response to the health system, compliance with international norms and the risk environment.
Thailand was ranked sixth overall, the best in Asean, where Malaysia was ranked 18th and Singapore 24th. Far behind were Vietnam (50th), Myanmar (72nd), Laos (73rd), and Cambodia (146th).
Dr Thanarak believes that with cooperation between the public and private sectors, the capacity of the healthcare system in Thailand can be greatly improved, increasing the chances of the situation being contained.
Dealing with the prospect of an epidemic, he explained, is divided into four phases. In phase one, the focus is on early detection of cases in travellers.
“The measures taken include setting up entry screening at airports and establishing surveillance in the health sector as well as the public.”
Phase two begins when local transmission starts to materialise, possibly from the travellers to local residents. This began after the first case of local transmission was reported in a Thai taxi driver who had never travelled to China but possibly contracted the virus from a Chinese passenger.
Phase three is the phase of acceleration if infections spread throughout the country. The focus would be on slowing the spread of the virus and elevating the capacity of the domestic healthcare system.
“It may not happen at all. But if it happens, we know what our government needs to prepare for,” said Dr Thanarak. “Of course, we prepare for the worst and work to be the best so that it won’t happen.
“If the worst case happens, I think we might suffer a little bit, but I think we can handle it.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
