S4:E5 Global Implications of the Coronavirus

Overview: Dr. Chantel Sloan gives us a rundown of the coronavirus and its implications on the global economy.

Guest: Dr. Chantel Sloan is a professor of health sciences at BYU. Dr. Sloan joined the faculty in the BYU Department of Health Science after completing a postdoctoral program at Vanderbilt University Medical Center. She received her Doctorate from Dartmouth College, and her bachelor’s degree from BYU-Hawaii. Dr. Sloan has researched a variety of topics in respiratory health, genetics and applications in Medical Geography.

Transcript

Grady: Hello everyone. This is Grady Reins on Cultural Conversations with IHub. Today we are so excited to have Dr Chantel Sloanm Professor in the Department of Health at Brigham Young University. Dr Sloan is an expert on disease prevention and control and today will tell us more about the coronavirus and its global implications on the world. Joining our conversation as well are Dr Oldroyd and Burton, professors at the Marriot School of Business and founding members of the International Hub.

Grady: Dr Sloan. We are so happy that you are able to be here with us today. Could you give us a brief sense of the Coronavirus.

Dr. Sloan: A sense of it. So this virus has been really grabbing worldwide attention. Mostly because of its similarity to similar respiratory viruses like Sars that have come out over the last 25 years. But it has exceeded in number of cases and in number of fatalities by quite a bit now. It is a respiratory virus that is traveling through China- caused a huge quarantine, some 50 million people put under quarantine for a couple of weeks now. And a lot of interesting stories coming out of that. The biggest quarantine experience the world has ever seen. A lot of resources going into tracking it and making sure it doesn’t spread in other countries as prolifically as it’s previous success. Yeah, so there are good reasons why it is grabbing global attention. 

Grady: And then how does it compare to other outbreaks that we have seen in the past?

Dr. Sloan: So every outbreak is a little bit different. When you look at some like Sars, the severe acute respiratory syndrome, was in like 2003 I believe. We saw a lot of similarities in that there was quarantine and what we call social distancing where people voluntarily separate themselves from each other. Staying at home from school and work. Cultural events and that kind of thing. Everyone is wearing masks. And that’s probably the most similar one. It was a virus from the same family- the respiratory family. And it also grabbed worldwide attention but didn’t spread as far, thankfully. 

Grady: Can you also tell us a little bit about the Coronavirus family, like you mentioned?

Dr. Sloan: Yeah, so the Coronavirus family is a genetic family of viruses that are spread through respiratory droplets. Both sneezing and coughing and potentially filamite spread. They cause a wide range of severity of symptom. It can be anything from just the common cold all the way to one of the pneumonias that can cause hospitalization or death. Most Coronaviruses just come and go like similar to a RhinoVirus which we refer to as the common cold virus. A lot of time it is not that serious, but we get these new novel ones that, just like getting a novel influenza can really throw us for a loop. 

Grady: And so then the correct name for this coronavirus is the Novel Coronavirus? 

Dr. Sloan: They’ve named it COVID-19, so essentially the Coronavirus from 2019. It’s a pretty bland name. 

Grady: And then what are the main symptoms that are  associated with this coronavirus?

Dr. Sloan: It’s very cold and flu-like. Runny rose, cough, and fever. Progressing through what many of us experience as a seasonal respiratory infection but it can become much more serious especially in people over 65. And that’s true of influenza as well- very similar. Their immune systems are waning a little bit and they might have more pre existing conditions. And also people who have things like lung disease, asthma, or diabetes. They can all make it much more seious. Or increase your risk of it becoming much more serious. 

Grady: And what do we know about the human to human transmission of the coronavirus?

Dr. Sloan: Well, we know it’s pretty contagious. Yes. We were hoping, when you have a virus that spill over from an animal population to a human population and it will not be that well adapted to a human population so it will have a lower level of contagion. But unfortunately that hasn’t been the case with this. The coronavirus, or COVID-19 as we are calling it now, that each person who is infected is expected to infect 2 other people. We call that the R-NOT number. The reproductive number of the virus. If you’ve ever seen contagion they totally describe this. For reference a typical respirational influenza will be between 1.5 and 2. So it’s about in that same range, or maybe a little more. The numbers are constantly fluctuating as we are getting more and more information

Grady: And with that, what do we know of the origin of the coronavirus? And how does that affect the disease?

Dr. Sloan: Yeah so the origin, last time I checked, is still being pinned down. It might have been transmitted through these animals called pangolins (I think that is one hypothesis). But it is a virus that occurs normally in bats. A lot of our new viruses come from bats. Tend to spread things pretty readily- there are a lot of them and they travel. So it may have spread from bats to some animal like a pangolin and then it infected a human. Possibly through a market place in Wuhan that was originally tagged as being a potential source. Even though a lot of the original cases were not traced back to that particular market. So there is still a little bit of mystery around what exactly happened. As of my last understanding, but again, this is changing every hour. 

Grady: Just a little background. How does a disease like coronavirus differ from something like small pox? 

Dr. Sloan: So actually most viruses that occur in humans originally came from an animal. Call it a mezonotic disease. And when that virus mutates in a way that it is able to effect a new species that is called spillover. And so influenza A that is infecting us all really bad right now (it’s really bad influenza A season) spills over from birds. Ebola spilled over from bats. There are a few diseases that originated in humans, where we are the reservoirs. Respiratory and social virus, which everybody gets by the age of 2, begins with RSV. Lots of people with little kids fear RSV, that is a disease that originated in humans. But that is in the minority. Most of them come from animals. 

9:05

Grady: Should we be concerned in the United States that there are more cases that are not diagnosed?

Dr. Sloan: Yeah, there are a lot of cases that have gone undiagnosed. And this is the tricky thing about following an epidemic in real time. You’ll see in the news, “Oh! Cases fell today (offering hope) and “Oh cases jumped by 2,000 today because of a new test.” And trying to follow it in real time like that and analyze trends day to day will cause a rollercoaster of emotions. Because we are getting new data and new tests and there are probably lots of cases that have not been laboratory confirmed and official. And I think we can have a moderate concern in the US, but I have more of a concern for the people in China and surrounding countries that have been more directly effected with it. Just in compassion and in empathy. We want to be careful in the US and make sure that people are screened and quarantined if they are coming from that area. But it’s not right now a major threat to our population. It’s not actively transmitting at a high level. 

Grady: And to what degree has culture had an effect on the transmission of the disease?

Dr. Sloan: Yeah, so there is this really interesting story of the original doctor who raised an alarm about this back in November/December having their voice essentially silenced by the government. But then these warnings turned out to be true. And unfortunately he ended up passing away from the same disease. So there has been this effect of the culture and especially the governmental influence over the sharing of information that has caused a lot of problems. On the flip side of that the government in China has a lot of resources and they were able to build a giant hospital in 10 days. Which a lot of people around the world, including the US, have looked at that and said, “Wow that’s pretty impressive that they could pull that off.” So I think that for better and worse culture. And probably more the political structures have had an influence.  

Grady: Can you expound on that? How the political structures have had an influence on that?

Dr. Sloan: Yeah, I think that the protection of data, the protection of image, and the government’s ability to respond has been interesting. And I think that’s a story that will continue to unfold. We will learn more and more about those early days of the outbreak and the epidemic. And how information was shared and to who and who they’ve allowed to provide relief and resources along the way. It’s been interesting. 

Grady: And then maybe a question to everyone in the room… How do we feel the coronavirus will impact the global economy?

Professor Burton: One of the concerns that many people have right now is whether or not they should travel to Asia. To Asia…not necessarily China but another country. They are worried about traveling there and then needing to be quarantined before returning to the United States. A lot of business travelers are thinking, “I don’t even want to entertain that risk right now so I am going to curtail my travel.” And that certainly is going to have an impact on the economy. And on the companies and the companies they do business with. Is that really a risk that travelers should be worried about? 

Dr. Sloan: Well, if they are traveling to a region with active spread of the virus. Well, for one, getting to those places is very difficult. Then they might be quarantined or some limitations on…say what materials they can bring back. But generally speaking they should be alright. The economic impact I’ve seen and we have more experts in economics and business than me for sure…has been a total shutdown of these cities. And all these people telecommuting. They are saying it is one of the largest telecommuting experiences we’ve ever had. 

James Oldroyd: Yeah, I think it’s going to be interesting. I mean this really is going to be an experiment because we’ve never had to shut down on this massive of a scale. Or this prolonged of a scale. And it will be interesting to see what kind of productivity…clearly the manufacturing sites that were closed first are starting to open again as the workers start to come back. And then there are just many many many people working from home for an extended period of time…you know…telecommuting. And we have never had that happen at this massive of a scale. It’s be interesting. The technologies are in place that theoretically it shouldn’t have that big of an impact on a lot of the businesses. It’ll be interesting to see if that plays out and these technologies really can proxy for the face to face communications of those travelers that are not going or are having skype or zoom meetings instead. Does that mean in the future that they’ll realize they didn’t need to go anyway? So it would be interesting as we move forward if this is a tipping point and we move to more technology as the median and curtail the travel. 

Greg Burton: Yeah, we’ll see what kind of an impact this has on tourism as well because people are shy about going any place. And even in some business settings the conferences that have been planned are being cancelled just so we don’t have a massive group of people meeting together. So those normal courses of education may have a longer term impact as well. But it is interesting we are in an environment now where there is technology that allows us to have these virtual meetings. And maybe, as professor Oldroyd mentioned, we realize we can cut down on travel because the technologies there were as effective.

Grady: What you say are some takeaways- things that we can learn from what the world has experienced with the coronavirus. Kind of an interdisciplinary thought from the different fields we have here. What are the things we can take away and learn?

Dr. Sloan: Well I think there is one lesson we are learning from epidemics over and over again. And that’s through SARS and MURS (which I’ve mentioned a couple of times) MiddleEast Respiratory System. The recent Ebola outbreaks and now COVID-19. And that’s neat to have good surveillance where we are receiving information about potential cases for novel viruses and we are listening to that information early because all of these things like quarantine, social distancing. They work the best when you start it early. And we could have taken those initial 11 people who were infected and done much more active follow up if we had acted a little bit earlier and avoided a lot of these consequences. 

17:25

James Oldroyd: It’s interesting because you look at health data or big data and you assume it’s changing the way we drive and we are optimizing the flow of traffic using big data. And businesses are becoming more efficient as they are looking through giant data sets and finding patterns. But it’s really transparencies that we need at the end of the day and that’s the potential of having that analysis done in a massive or even global scale looking at infection rates. We could do a lot if we had a mechanism to make that happen. The problem is that to have that happen is really really difficult. 

Greg Burton: So we kind of expect with the advancing technology and also maybe being faster at diagnosing things and having massive data sets to have something to make conclusions faster. Might be a boon to our public health in the future. Have you noticed that?

Dr. Sloan: You know, there are a lot of really great surveillance programs around the world where people are try to collaborate and say where are the new viruses coming from? But funding for them can shift. The US actually until recently had a program (I believe it was called ‘Predict’ trying to identify possible new sources of viruses in animals that could spill over into humans. But it was recently defunded and has been inactive. So those kinds of programs are really important to prevent these kinds of scenarios. The WHO has surveylance and a watch list for the top diseases that they are keeping an eye on to see if this is going to move over into humans or is this past epidemic we’ve seen and it could come up again in a much bigger way. So there are a variety of these programs that are working to collect these data and make them available. But the amount of funding they receive, the amount of political support they receive can vary by time and location. 

James Oldroyd: So could you just talk about… I’m just curious about the mortality rate…of COVID-19. How does it compare to the common cold.. Or Ebola or others? Does it have a much higher mortality rate?

Dr. Sloan: So far we’ve had 11,0000 confirmed cases and about 1,000 deaths or something like that. The actual case and death counts are shifting constantly. A really good solid mortality number I think is gonna be forthcoming. It does have a much higher mortality than the common cold. But much lower than something like Ebola where, if left untreated, could be 40-50%. Especially in malnourished populations. So definitely not the mortality rate of something like Ebold or a bird flu. And really not even as high as our seasonal flus that are going around right now. So hopefully this is a reminder to everybody to take higene caution; handwashing, staying home when sick with flu. Because it’s worse right now in the US right now than COVID-19.

21:10

James Oldroyd: So could you put that in numbers and tell us what that means?

Dr. Sloan: It’s different every year.