By Sharon Lili Elhadad, M.A. and Dana Elhadad, M.Sc

Throughout history emerging infectious diseases have shaped the course of human history and have caused incalculable misery and death. New advances in science, technology and medicine have helped us gain ground against certain infectious diseases. However, even in the twenty-first century infectious diseases continue to emerge at a rapid pace. Many Emerging Infectious Diseases (EIDs) have been catalyzed by wars, loss of social cohesion, and natural disasters. Under these conditions and in addition to microbial or viral virulence factors, a contagious disease may lead to an epidemic outbreak. An epidemic is categorized as a fast growing outbreak that affects many people almost instantly, usually within a city. If the epidemic is not sufficiently contained it can become a pandemic outbreak, that has no social or geographical boundaries.

EIDs pose a major risk to the health and welfare of global human and animal populations. The staggering impact on a population can be both directly and indirectly. Human populations are directly at risk from infection and indirectly at risk through the impact on their food supply. The risks associated with food supply include the economic losses related to the culling of animals and the unavailability of food caused by real or suspected contamination. In addition epidemics have the potential to severely disrupt global supply chains and further harm human health. An epidemic’s impact on the economy can vary based on its imminent and long-term severity. This is influenced by the rate of hospitalizations, insurance premiums, outpatient visits and the largest contributor, death. Most economic models agree that death causes the greatest economic decline with a yearly cost of billions on the economy.

The seasonal flu is a contagious respiratory disease that is caused by influenza viruses. It occurs every year and while it is not usually severe in healthy individuals it may cause serious illness and even death in people with weak immune systems. Influenza viruses pose remarkable impacts on socio-economy, such as costs of medical care, loss of productivity, and deaths. To date, only a small number of studies have estimated the economic impacts of influenza in the US. According to the Centers for Disease Control (CDC) seasonal flu outbreaks cost US employers an estimate of $10.4 billion in direct costs of hospitalization and outpatient visits, not including the indirect costs related to lost productivity and worker absenteeism. Immunization against influenza can effectively reduce the annual economic burden of influenza in the United States. Nevertheless, despite efforts to vaccinate those at highest risk of severe influenza-related complications, many still go unvaccinated. 2013 was one of the worst flu seasons in a decade with 5.6% of people seeing health care providers due to flu like symptoms. This is almost twice the national average (2.8%) according to the CDC. The increased percentage of infected individuals has put further strains on an already sluggish US economy as companies get slammed with increased health care costs and lower productivity from widespread worker absences.

A pandemic flu is different because it is caused by a new form of flu that the general population is naive to. Since the human host has near to no immunity and is not prepared to fight it , a pandemic flu can cause a worldwide outbreak which spreads easily from person to person such as the Severe Acute Respiratory Syndrome (SARS-2003) , the bird flu (1997) and the pig flu (H1N1 flu virus 2009). While a seasonal flu has a manageable impaction on domestic and global economy a pandemic flu has the potential for a severe economic crisis. A worldwide influenza pandemic could have a major effect on the global economy including travel, trade, tourism, food, consumption and eventually, investment and financial markets. Planning for pandemic influenza by business and industry is essential to minimize a pandemic’s impact.

Unlike the flu that is considered a “random” epidemic that rises exponentially and then declines within weeks or months, the AIDS epidemic has redden steadily since 1980 and tends to infect certain high risk subpopulations. The costs for countries unable to contain the HIV virus are substantial and persist for decades. Unfortunately, nations with the greatest prevalence of the disease tend to have the lowest standards of living and slowest economies. This is usually cased by the lack of resources necessary to combat the costs of the epidemic. Russia, for example, is home to one of the fastest-growing HIV and AIDS epidemics in the world, abetted by policies that promote infections rather than curbing them. With 1.8 million people injecting drugs, around 2.3% of the Russia’s populations, HIV prevention services are largely inaccessible in Russia. Opioid Replacement Therapy is banned and in 2008, only 7% of Russians injecting drugs had access to clean needle exchange programs. Russia along with the former Soviet states of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan have experienced a climb in rates for HIV since the Union of Soviet Socialist Republics (USSR) broke down in 1991. No country is immune to epidemics and their impact on the economy and society therefore prevention and policy will play a strong role. As evidence suggests an increase in policy and education, with a major focus on communities, will provide a starting point for economic growth.

In addition to newly emerging infectious agents, certain virus can re-emerge in the human population overtime. A most recent example of this would be the re-emergence of the Ebola virus. By far the largest outbreak of Ebola virus disease ever recorded is currently occurring in West Africa. With a tight grip on West Africa, tracing its first case of Ebola back to a 21-year-old student from neighboring Guinea, the virus has now spread to Senegal the fifth country in Africa to be affected. While pharmaceutical companies around the world are scrambling to find a cure, the region’s economy is feeling the pinch. There is a 90 percent death rate for those who contract the virus and over 3,000 people have been diagnosed and more than 1,500 people have died since the beginning of the outbreak, which has been traced back to last December. The World Health Organization (WHO) has warned the international community of the epidemic’s acceleration, announcing its potential to grow six times larger and can infect as many as 20,000 people. Aside for the heavy human toll, the epidemic is causing people to cancel projects, and business people are leaving the country. Even though the WHO has not issued any travel bans, some African countries, such as Kenya, Senegal and South Africa, do issue travel restrictions to the affected nations. This has greatly affected tourism, trade and agriculture. Agriculture accounts for some 40 percent of the economic output in Liberia and Sierra Leone and a quarter in Guinea. This sector is taking the greatest hit in the three countries as farmers are forced to leave the fields, and cannot trade across borders because many have closed. Even some less intuitive markets like the diamond market have been affected by the Ebola outbreak. Sierra Leone’s goal for the year 2014 had been to export $220 million worth of diamonds. This goal will not be reachable, as miners are afraid to go to work because the diamond fields are located in the hardest hit areas.

 

Photo: WHO, Health Ministry DRC and Senegal

Photo: WHO, Health Ministry DRC and Senegal; August 29, 2014

 

Pandemics have accompanied human evolution from ancient times to modern civilization. Today, despite our advances in laboratory science, the basic means of addressing infectious diseases remain the same as those nearly a century ago. Public health education, isolation, sanitation, lessening congestion, closures, and surveillance are essential tools. Moreover, appropriate use of vaccines, antiviral drugs and pandemic preparedness plans would greatly reduce the impact caused by the disease. Given our highly mobile and connected society any future pandemic is likely to be more severe in its reach and perhaps in its virulence. EIDs are not preventable, however mitigating its impact on the operational integrity of critical national infrastructure, private industry, and global trade is possible. Mitigating will require social, political, and economic commitments across governments and industries, as well as through unique public-private partnerships. We must do everything in our power to appropriately prepare to deal with the disease in addition to its ramifications on the healthcare system, the economy, and society.