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Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

India continues to remain ranked 43rd on an annual World Competitiveness Index compiled by Institute for Management Development (IMD) with some traditional weaknesses like poor infrastructure and insufficient education investment keeping its ranking low, the international business school said on Tuesday.

Singapore has retained its top position on the 63-nation list.

Denmark has moved up to the second position (from 8th last year), Switzerland has gained one place to rank 3rd, the Netherlands has retained its 4th place and Hong Kong has slipped to the fifth place (from 2nd in 2019).

The US has moved down to 10th place (from 3rd last year), while China has also slipped from 14th to 20th place. Among the BRICS nations, India is ranked second after China, followed by Russia (50th), Brazil (56th) and South Africa (59th).

India was ranked 41st on the IMD World Competitiveness Ranking, being produced by the business school based in Switzerland and Singapore every year since 1989, but had slipped to 45th in 2017 before improving to 44th in 2018 and then to 43rd in 2019.

While its overall position has remained unchanged in the 2020 list, it has recorded improvements in areas like long-term employment growth, current account balance, high-tech exports, foreign currency reserves, public expenditure on education, political stability and overall productivity, the IMD said.

However, it has moved down in areas like exchange rate stability, real GDP growth, competition legislation and taxes.

Arturo Bris, Head of Competitiveness Center at IMD Business School, said India continues to struggle on the list and the recent country rating downgrade by Moody’s reflects the uncertainties regarding the economy’s future.

"In our ranking this year, we again emphasize the traditional weaknesses of India -- poor infrastructure, an important deficit in education investment, and a health system that does not reach everybody. For India to follow the path of China, it must stress its intangible infrastructure," Bris said.

"In a less global world, with China, USA, and Europe looking inwards, currencies like the rupee (and the Brazilian real for instance) are going to suffer and display high volatilities.

"Moody’s has threatened the country with a downgrade to junk and that would put India in a terrible position to attract foreign capital. So the urgency for the government should be to fix the short-term problems—and this requires to improve the credibility of the government itself," Bris added.

With the exception of Singapore, the Philippines, Taiwan and the Korean Republic, most Asian economies dropped in rankings this year, the IMD said.

The reason for the Asian economies’ less stellar performance as a region, this year is partly the result of the trade frictions between China and the US, particularly because these economies are highly dependent on trade with China.

About Singapore, which moved to the top rank last year, the IMD said its position is largely driven by the relative ease of setting up business, availability of skilled labour and its cutting-edge technological infrastructure.

The IMD said the impact of COVID-19 on the competitiveness ranking has partially been captured by executives’ opinions about the effectiveness of the different health systems.

In the ASEAN countries included in the survey, only Singapore and Thailand have a positive performance in the effectiveness of the health infrastructure.

May 8: Thousands of migrants have been stranded “all over the world” where they face a heightened risk of COVID-19 infection, the head of the UN migration agency International Organization for Migration (IOM) has said.

IOM Director-General António Vitorino said that more onerous health-related travel restrictions might discriminate disproportionately against migrant workers in future.

“Health is the new wealth,” Vitorino said, citing proposals by some countries to introduce the so-called immunity passports and use mobile phone apps designed to prevent the spread of the new coronavirus.

“In lots of countries in the world, we already have a system of screening checks to identify the health of migrants, above all malaria, tuberculosis… HIV-AIDS, and now I believe that there will be increased demands in health controls for regular migrants,” he said on Thursday.

Travel restrictions to try to limit the spread of the pandemic has left people on the move more vulnerable than ever and unable to work to support themselves, Vitorino told journalists via videoconference.

“There are thousands of stranded migrants all over the world.

 “In South-East Asia, in East Africa, in Latin America, because of the closing of the borders and with the travel restrictions, lots of migrants who were on the move; some of them wanted to return precisely because of the pandemic,” he said.

They are blocked, some in large groups, some in small, in the border areas, in very difficult conditions without access to minimal care, especially health screening, Vitorino said.

“We have been asking the governments to allow the humanitarian workers and the health workers to have access to (them),” he said.

Turning to Venezuelan migrants, who are believed to number around five million amidst a worsening economic crisis in the country, the IOM chief said “thousands… have lost their jobs in countries like Ecuador and Colombia and are returning back to Venezuela in large crowds without any health screening and being quarantined when they go back”.

In a statement, the IOM highlighted the plight of migrants left stranded in the desert in west, central and eastern Africa, either after having been deported without the due process, or abandoned by the smugglers.

The IOM’s immediate priorities for migrants include ensuring that they have access to healthcare and other basic social welfare assistance in their host country.

Among the UN agency’s other immediate concerns is preventing the spread of new coronavirus infection in more than 1,100 camps that it manages across the world.

They include the Cox’s Bazar complex in Bangladesh, home to around one million mainly ethnic Rohingya from Myanmar, the majority having fled persecution.

So far, no cases of infection have been reported there, the IOM chief said, adding that preventative measures have been communicated to the hundreds of thousands of camp residents, while medical capacity has been boosted.

Beyond the immediate health threat of COVID-19 infection, migrants also face growing stigmatization from which they need protection, Vitorino said.

Allowing hate speech and xenophobic narratives to thrive unchallenged also threatens to undermine the public health response to COVID-19, he said, before noting that migrant workers make up a significant percentage of the health sector in many developed countries including the UK, the US and Switzerland.

Populist narratives targeting migrants as carriers of disease could also destabilise national security through social upheaval and countries’ post-COVID economic recovery by removing critical workers in agriculture and service industries, he said.

Remittances have already seen a 30 per cent drop during the pandemic, Vitorino said, citing the World Bank data, meaning that some USD 20 billion has not been sent home to families in countries where up to 15 per cent of their gross domestic product comes from pay packets earned abroad.

Vitorino, in a plea, urged to give the health of migrants as much attention as that of the host populations in all countries.

“It is quite clear that health is the new wealth and that health concerns will be introduced in the mobility systems - not just for migration - but as a whole; where travelling for business or professional reasons, health will be the new gamechanger in town.

“If the current pandemic leads to a two or even three-tier mobility system, then we will have to try to solve the problem – the problem of the pandemic - but at the same time we have created a new problem of deepening the inequalities,” he said.