Preventing and controlling the spread of infectious diseases is one of the arguments for strong government institution. However, this argument is undermined if governments address emerging epidemic diseases in a terrible way.
Concerns over responsibility and reputation all too often take precedence over the real tasks of saving human lives. Take a look below for 7 failed official attempts to control epidemics.
1. SARS In China
The SARS epidemic appears to have started in Guangdong Province, China, in November, 2002, where the first case was reported that same month. The patient, a farmer from Shunde, Foshan, Guangdong, was treated in the First People’s Hospital of Foshan. The patient died soon after, and no definite diagnosis was made on his cause of death.
Despite taking some action to control it, Chinese government officials didn’t inform the World Health Organization of the outbreak until February, 2003. This lack of openness caused delays in efforts to control the epidemic, resulting in criticism of the People’s Republic of China from the international community. China has since officially apologized for early slowness in dealing with the SARS epidemic.
In early April, after Jiang Yanyong pushed to report the danger to China, there appeared to be a change in official policy when SARS began to receive a much greater prominence in the official media. Some have directly attributed this to the death of American James Earl Salisbury. It was around this same time that Jiang Yanyong made accusations regarding the under-counting of cases in Beijing military hospitals.
After intense pressure, Chinese officials allowed international officials to investigate the situation there. This revealed problems plaguing the aging mainland Chinese healthcare system, including increasing decentralization, red tape, and inadequate communication. Many healthcare workers in the affected nations risked and lost their lives by treating patients and trying to contain the infection before ways to prevent infection were known.
2. MERS In South Korea
South Korea reported its first MERS case on May 20, 2015. A 68 year old man returning from the Middle East was diagnosed with MERS nine days after he initially sought medical help. However, the Ministry of Health and Welfare didn’t disclose the relevant information to the public at the beginning of the outbreak. According to them, disclosing the names of medical institutions that are hospitalizing the MERS patient might cause unnecessary anxiety to the facility users.
Such action wasn’t welcomed by the public and the Ministry’s action to regulate the outbreak was heavily criticized due to its inability to properly disclose the information to hospitals and municipal government.
On June 3, 2015, it was found that the Ministry didn’t notify the Incheon municipal government about the transfer of infected patients to its local medical institution. On June 4, 2015, the Seoul municipal government disclosed that a 35th infected patient had been discharged, unaware of the infection, and had moved freely within Seoul city, but wasn’t notified of such patient b the Ministry, but rather, was found out by the Seoul government official.
After 2,361 people were isolated, 64 patients were infected and 5 infected patients died, the central government finally disclosed the names of MERS exposed medical institutions on June 7, 2015.
3. Cholera In Zimbabwe
The 2008 Zimbabwean cholera outbreak was an epidemic of cholera affecting much of Zimbabwe from August, 2008, until June, 2009. The outbreak began in Chitungwiza in Mashonaland East Province in August, 2008, then spread through the country so that by December, 2008, cases were being reported in all 10 provinces.
In December, 2008, the Zimbabwean government declared the outbreak a national emergency and requested international aid. The outbreak peaked in January, 2009, with 8,500 cases reported per week. Cholera cases from this outbreak were also reported in neighboring countries South Africa, Malawai, Botswana, Mozambique and Zambia.
With the help of international agencies, the outbreak was controlled, and by July, 2009, after no cases had been reported for several weeks, the Zimbabwe Ministry of Health and Child Welfare declared the outbreak over. In total, 98,596 cases of cholera and 4,369 deaths were reported, making this the largest outbreak of cholera ever recorded in Zimbabwe. The large scale and severity of the outbreak has been attributed to poor sanitation, limited access to healthcare, and insufficient healthcare infrastructure throughout Zimbabwe.
4. Nipah Virus In Malaysia
An outbreak of the newly emergent paramyxovirus Nipah in the state of Perak, Malaysia, in September 1998 was initially assumed by the government to be an outbreak of Japanese encephalitis, which is endemic in Malaysia, spread by mosquito, and primarily affects children. The Nipah virus, by contrast, caused severe febrile encephalitis among pig farmers.
It had been spread from flying foxes to pigs to humans through bat excretions landing in pig swill, possibly due to the migration of fruit bats to cultivated orchards due to fruiting failure in forests caused by El Nino and human burning efforts.
The Malaysian government’s initial attempts to control what it thought was Japanese encephalitis through fogging and mass vaccination had no effect on the spread of the disease. When cases were reported in abattoirs in Singapore in March 1999, the country banned the import of Malaysian pigs and controlled their small outbreak.
The outbreak of the disease in Malaysia was finally controlled with the culling of over one million pigs, while people were advised to conduct preventative measures such as using protection like masks, hand-washing after handling infected animals and pigsties, and washing down cages and vehicles for transporting animals with soap and water.
The disease wreaked havoc on the billion-dollar Malaysian pig industry, and a group of pig farmers tried to sue the government for their mishandling of the case. The farmers were angry to have engaged in fruitless efforts to control the misidentified virus, which led to more deaths and the destruction of many livelihoods.
5. Plague In India
The 1994 plague in India was an outbreak of bubonic and pneumonic plague in south-central and south-western Indian from August 26 to October 18, 1994. 693 suspected cases and 56 deaths were reported from the five affected Indian states as well as the Union Territory of New Delhi.
In the first week of August 1994 health officials reported unusually large numbers of deaths of domestic rats in Surat city of Gujarat state. On 21 September 1994 the Deputy Municipal Commissioner of Health for Surat city received a report that a patient had died seemingly due to pneumonic plague. The DMCH of Surat alerted medical officers in the area where the patient had died.
Later that day, a worried caller informed DMCH about 10 deaths in Ved Road residential area and around 50 seriously ill patients admitted to the hospital. This triggered the biggest post-independence migration of people in India with around 300,000 people leaving Surat city in 2 days.
News of the Plague spread through Surat city through the night of 21 September 1994. Ill-prepared, medical shops quickly exhausted stocks of tetracycline. This led to panic with people fleeing hospitals fearing infection from other sick patients.
Due to the migration of infected people from Surat city, suspected plague spread to five states. A total of around 52 deaths were reported from India due to this suspected plague outbreak. Over the course of this event, many flights from India to the nearby Gulf region were suspended. Some countries also put a hold on the imports from India.
6. BSE In Britain
The epidemic of bovine spongiform encephalopathy, or mad cow disease, began with the death of a single cow in West Sussex. While it first appeared in the 1970s, it had largely gone unnoticed but would eventually jump to humans. Controlling the outbreak involved the culling of millions of livestock, and the disease killed 176 British and 50 others around the world. The outbreak caused severe doubts in the reliability and honesty of UK governments in handling such outbreaks.
At first, the government denied any link between BSE and the human variant, Creutzfeldt-Jakob disease. Agriculture Minister John Gummer criticized schools that had taken beef products from their menus over the rising fears. At a political event in 1990, he tried to prove properly cooked British beef safe by feeding a hamburger to his daughter. She refused, so he took a bite himself and called it “absolutely delicious.”
It took until 1996, after several human cases had already been reported, before the government was willing to admit the danger posed by BSE. A 2000 report lauded government efforts to control the outbreak but admitted denialism and delays hampering the process. Poor communication and foot-dragging by civil servants, bureaucratic hurdles, and poor enforcement also made things worse. One key failure was the 1987 decision not to ban mechanically recovered meat from carcasses, considered risky, which then entered burgers and meat pies.
7. Spanish Flu In Samoa
On November 7, 1918, the New Zealand passenger and cargo ship Talune arrived at Apia from Auckland. On board were people suffering from pneumonic influenza, a high infectious disease already responsible for hundreds of thousands of deaths around the world. Although the Talune had been quarantined in Fiji, no such restrictions were imposed in Samoa. Sick passengers were allowed to disembark.
The disease spread rapidly through the islands. Samoa’s disorganized local health facilities and traumatized inhabitants were unable to cope with the magnitude of the disaster and the death toll rose with terrifying speed. Grieving families had no time to carry out traditional ceremonies for their loved ones. Bodies were wrapped in mats and collected by trucks for burial in mass graves.
The total number of deaths attributable to influenza was later estimated to have reached 8500, or 22% of the population. According to a 1947 United Nations report, it ranked as “one of the most disastrous epidemics recorded anywhere in the world during the present century, so far as the proportion of deaths to the population is concerned”.
Survivors blamed the New Zealand Administrator, Lieutenant-Colonel Robert Logan, for failing to quarantine Talune and for rejecting an offer of medical assistance from American Samoa. A Royal Commission called to enquire into the allegations found evidence of administrative neglect and poor judgement.