The diverging story of MERS and EBOLA impacts on different countries

Hey guys! Has any of you ever wondered,

Why does one country suffer more from an outbreak than the other?
Why do the same virus becomes more of a threat for a certain population?

Unsurprisingly, it has a lot to do with cultural and health-behaviour of the

people.

South Korea had an unexpected MERS outbreak in 2014, carried by a

businessman on who was back from a 9-day business trip in Saudi Arabia.
The initial reaction was clear. People are terrified to go to the street and
government shot down schools and office (as many as 2,900 of them) [1] ,
while 3600 of the citizens were put under tight monitoring for symptoms.

 Doctors without Borders

However things can be said to even be worse in the West African Trio, which
suffered the most from another outbreak (arguably with bigger damage),
Ebola. Liberia, Guinea, and Sierra Leone had been struggling with education
to start with. Before Ebola hit, their education coverage was 70% and 60% for
male and female students respectively in primary school, the number is
halved in secondary school as students are forced to help earning for their
family, or (tragically) recruited as child soldiers. Ebola crippled an already
struggling system and the outbreak pushed the once progressively rising
education coverage several years back. Experts pointed out as well factors
that made things worse: seven months without school, with inadequate effort
to replace it (radio education - a joint government effort - was deemed
inefficient by most). Additionally, the high rate of students contracted with
Ebola, or has a family member contracted with Ebola, all further deteriorated
the problem [2].

As the disease progressed and drew more attention, interesting observations

in local health behaviour can also be made on why the disease is not
contained well in several areas. For instance, in Middle East, the suspected
carrier species are camels, their main domesticated animal. They are an
important part of the peoples history, culture, and even just in everyday live.
The camel farmers and traders firmly stood by their animal saying things in the
line of "We have not heard of anyone who has been hospitalized" and
continued to do what the government describe as 'risky behaviour, i.e. eating
their meat and drinking raw camel milk.

Meanwhile in Africa, village people are raiding Ebola quarantine centre for
murdering their family members (to be fair, initially hardly anyone came out
alive), raising fear that several Ebola positive patients are on the street,
potentially spreading the virus.

Even in more developed countries such as the USA and South Korea, impact
of health behaviour can result to a different end of an outbreak. During the
time the two American health workers (back from Guinea) are the only
reported case of MERS in America, while in South Korea the case exploded
to involve another 200 people and caused more than 30 deaths following the
first case.[3]

We may wonder, why is that? What makes them different?

Well, first, is the early identification. The two American health workers were
immediately isolated after suspicion rise following the emergence of their
symptom. This was not the case in South Korea. Second, and (paradoxically)
unfortunate for South Korea, their universally accessible health coverage
assisted in spreading MERS from one hospital to another. The large volume of
visit in the hospital and health care center also means that its been spread to
the street further causing damage [4].

Additionally, family members in Korea, as in many other Asian countries, often

stand by near the patients and assist with ward duties including bathing the
patient and changing the sheet, likely without adequate protection. The high
exposure to the contagious patient then casue them to in turn be sick. This is
not the case in United States in which patients are more strictly isolated with
stricter rules also generally imposed on visitors[4].

After the immediately recognisable social impact, comes economical and

political impact.

To calculate a complete economic setback from Ebola and MERS per se will
require some time and also a lot of expertise, however some major sectors
problem can already be identified following the outbreak.

The economical hit strikes hard to the the small sector industries. Economic
experts point out that the outbreak came during the time of many economic
difficulties, in conjunction with other economical threats from Greek
crisis, China stock market crash, and many others. Domestic buying power
has been low and such outbreak continue to stifle the domestic consumer
spending in affected countries.

Tourist section was also devastated, since SARS outbreak in 2003, which
resulted in 8000 infection and 800 deaths, the global citizen are more cautious
and tend to cancel their trips rather than risking a potentially fatal health
hazard, fear of Ebola and MERS not excluded. Local government also release
travel warning that further discourage the trip to countries with reported MERS
outbreak.

In South Korea, as many as 15% tourist arrival was cut during 2015, the year
that the first outbreak case is declared. I then grew to be a health problem that
dent the $30 billion tourism industry. It was predicted that even 15% drop in
tourist visit will result in 0.1 fall in the countrys GDP growth [4]. However the
30 billion tourism industries have started regaining its visitor lately. This was
unfortunately not the case for the West African countries affected by Ebola.
Despite continuous government effort to show restoration after the disease hit,
and declaration of Ebola-free country, visitors and investors alike are still
reluctant.

Therefore, even when the actual MERS case has worn off with last case
reported on July 2014, and the last Ebola case is reported in 2015, the
economic threats it is causing is expected to remain for several months after
[4].

Politics is also impacted in the outbreak. A direct consequence of Ebola was

also that despite the loss experienced by the affected country, many
neighbouring governments refused to have anything to do with the local
government. Al Jazeera even went as far as calling the The biggest concern
of the Ebola outbreak is political, not medical, reflecting the thinning trust

between West African governments, their citizen, and the neighbouring

governments.

President Park of South Korea also experience first hand how her reputation
is hurt by the outbreak. Her response was already deemed inappropriate and
not quick enough during the Ferry incident last year, and MERS was adding to
the already distrusting citizens. She was criticised to be late in recognising a
national crisis and she was put in the spotlight by international media.

In many ways politics also impact how disease is perceived and how people
can get together to stand in times of difficulty. South Korean government effort
to (what the people perceived at least) was also unappreciated, and resulted
in many inaccurate informations (The Huffington Post called them MERS
Ghost Stories), which did not help calm down the scared citizens (if
anything, made them more paranoid). Lesson was well learnt: Legit,
accurate information from a trustworthy government is required to handle the
crisis as a sovereign and united nation.

Therefore diseases like Ebola and MERS is just not a disease debilitating the
peoples health, it causes multiple damage on many levels in social,
economical, and political factor.

A couple of nanometers virus, a colossal impact.

[1] http://www.theguardian.com/world/2015/jul/28/south-korea-mers-virusoutbreak-is-over
[2] http://reliefweb.int/report/liberia/assessment-effect-ebola-education-liberiafebruary-2015

[3] http://asiasociety.org/korea/mers-impact-differing-tale-2-countries
[4] http://blogs.wsj.com/economics/2015/06/10/how-mers-could-affect-southkoreas-economy/

So are Ebola and MERS a worldwide threat?

Although the news got us at the edge of our seats, and the dire consequences
are real, the plain truth is. No.
Yes, you read right, no its not a worldwide threat.
Simply put, the virus itself is not very contagious (read our explanation on
scientific background and historical perspective here and here), there has to
generally be prolonged exposure to body fluid. Additionally, culturally, the
health awareness and behaviour of the people here makes early detection
and isolation of the case possible (see what happens otherwise in the
symptoms
and
signs).
Furthermore, WHO and all the countries are far more aware on the matter
now, so quick initial reaction and handling of the problem can be expected.
But is there the possibility of a threat? Of course, due to the natural
characteristic of the virus. But the chances are small, and should not be a
primary concern at all at the moment. Phew!