BC High MUN 29 Hello Everyone, My name is John Flanagan and I am chairing along with a friend of mine, Malcolm Flaherty. We are both juniors at BC High and I attended the BC High conference last March as a delegate representing Qatar in regards in attempt to find a way to create a healthy earth. I wish I had prepared more. I would have been a more effective delegate. Nevertheless, I am grateful to be given the opportunity to lead a very familiar topic to all of the delegates, and eager to make meaningful progress in a very current and serious topic. I just hope that no one makes the same mistake as I did, because work gets done when you do your research. For Malcolm, John Flanagan’22 My email address is [email protected] and Malcolm’s is [email protected] BC High MUN 29 Introduction to the Topic: The majority of this background guide came from the World Health Organization, NAIMUN (North American Invitational Model UN at Georgetown University), University of North Carolia Model UN, and the New York University Model UN. Statement of the Problem Terms like Novel-Coronavirus, Novel Ebola and Zika Virus stand out as the most headline grabbing epidemics in working memory, at least in Western Media. COVID-19 is the disease caused by a new coronavirus called SARS-CoV-2. The World Health Organization (WHO) first learned of this new virus on 31 December 2019, following a report of a cluster of cases of ‘viral pneumonia’ in Wuhan, People’s Republic of China. Though the Ebola and Zika virus were centered in West Africa and Brazil respectively, fear of the diseases spread like wildfire across the world. In our current state of global interconnectedness, where one can step on a plane in Chicago and wake up on a different continent, and with increasing rates of urban density, disease has the opportunity to spread further and faster than ever before.1 What were once local or regional outbreaks have the potential to arrive on the doorstep of any nation, thus making any infectious disease on one part of the planet the concern of every nation. Delegates should arrive in committee with an understanding of where efforts can be made to improve the response to an epidemic at every step along the path of progression: from 1 Hannah Ritchie and Max Roser, “Urbanization,” Our World in Data, June 13, 2018, https://ourworldindata.org/urbanization. BC High MUN 29 prevention, to identification, to tracking, to quarantine, and hopefully to elimination of the disease. The Nature of Pandemic Disease The current definition of an epidemic is the “occurrence in a community or region of cases of an illness, specific health-related behavior, or other health-related events” that occur in excess of what is normally expected.2 While in an epidemic the location and time period in which the cases happen are specified, the number of cases depends on a variety of factors, including the size of the community, type of population exposed, and whether the region has been previously exposed to the disease. A pandemic, on the other hand, implies an epidemic that occurs “over a very wide area, crossing international boundaries and usually affecting a large number of people”.3 This term fails to include any specific definitions regarding population immunity, virology, or disease severity, aspects that are vital to addressing public health concerns. The consequences of the failure to include certain topics in the definition of a pandemic can be seen in the ongoing debate between interpretations of seasonal vs pandemic influenza. The main distinction between the two is characterized by the time of year that influenza takes hold. Although seasonal influenza does cross international borders and affects a large number of people, the fact that the virus occurs annually is important. A true influenza pandemic occurs when an out-of-season, almost simultaneous, transmission takes place world-wide.4 2 “WHO | Definitions: Emergencies,” WHO, accessed May 17, 2019, https://www.who.int/hac/about/definitions/en/. 3 Last, Spasoff, and Harris, A Dictionary of Epidemiology. 4 “WHO | The Classical Definition of a Pandemic Is Not Elusive,” WHO, accessed May 17, 2019, https://www.who.int/bulletin/volumes/89/7/11-088815/en/. BC High MUN 29 While it was easy to identify a pandemic, the classical definition failed to describe the influenza pandemic in terms of the potential range of transmissibility and disease severity. The consequence was a slow response to the virus. Spread of Disease In addressing pandemics and health crises, it is necessary to identify the ways that diseases can spread. One of the most common types of diseases are airborne diseases. These diseases can spread through the air as small droplets or tiny aerosol particles. The germs in these droplets can often live on surfaces and spread when people touch those surfaces.5 Another transmission route is that of fecal spread. Some infections can be spread when microscopic amounts of feces from an infected person are taken in by another person by mouth.6 Sometimes this occurs directly from soiled hands to the mouth or indirectly by way of objects, surfaces, food, or water. More generally, infections can be spread through blood or other body fluids. This occurs when an infected person comes into contact with the bloodstream or mucous membranes of an uninfected person, such as through kissing or breastfeeding.7 Furthermore, viruses and bacteria can be spread through food, as hygiene, preparation, and safety practices regarding food differs between nations and cultures.12 Other ways in which infectious diseases can spread is through sexual contact, contact between animals or insects and humans, and even contact 5 “Understand How Infectious Diseases Spread | Travelers’ Health | CDC,” accessed May 19, 2019, https://wwwnc.cdc.gov/travel/page/infectious-diseases. 6 Lorna Fewtrell and Jamie Bartram, eds., Water Quality: Guidelines, Standards, and Health: Assessment of Risk and Risk Management for Water-Related Infectious Disease, World Health Organization Water Series (GeneVa: World Health Organization, 2001). 7 “Understand How Infectious Diseases Spread | Travelers’ Health | CDC,” accessed May 19, 2019, https://wwwnc.cdc.gov/travel/page/infectious-diseases. 12 Ibid. BC High MUN 29 between a mother and an unborn child. Although it may be easy to impose restrictions on the interactions between individuals and between people and their environment, it is important to recognize that there are cultural practices that may facilitate the spread of diseases. disaster preparedness. Globalization One aspect of globalization that warrants further investigation is how the wide-ranging changes associated with it are affecting infectious diseases and epidemiology. The rate of infection depends on a mix of biological and social factors. Transmission is not only affected by the type of infecting agent but also by the living conditions of the human population in which the agent is being spread, including the social and cultural practices, as well as, the population size, age-distribution and population density.8 Changes in any of those variables can influence the emergence, re-emergence, or disappearance of certain infectious diseases. It is necessary to note that there is likely no one change in global trends that can be pointed to as the root cause of increased disease transmission. chances of successfully implementing measures to prevent, control and treat infectious diseases. One impact of globalization is that individuals and population groups respond differently to change. This causes differences between populations in vulnerability to infectious diseases. Globalization is creating greater inequities within and across member states, which in turn enables infectious diseases to disproportionately affect the poor.9 Whether it is due to inequities 8 Special Programme for Research & Training in Tropical Diseases (TDR), “Globalization and Infectious Diseases: A ReiVew of the Linkages” (UNICEF/UNDP/World Bank/WHO, 2004). 9 Ibid. BC High MUN 29 in basic living conditions or the availability of and access to health care in certain areas, there is strong indication that poorer populations do not receive as many benefits of globalization and, therefore, innovations of infectious disease prevention Current Resources to Respond to Epidemic We are continuously reminded of the ways that people all over the world are vulnerable to infectious diseases, known and unknown. Will history continue to repeat itself? The answer must be yes and that is why current epidemic response resources are key to understanding how to respond to pandemics. The World Health Organization currently maintains an emergency response framework that is guided by various principles including country focus, evidence- based programming, partnership, accountability, and gender, age, and vulnerability sensitivity.10 Furthermore, the WHO focuses on the epidemic phases when developing ways to stage response interventions. The dynamics of diseases typically occur in four phases: introduction or emergence, localized transmission, amplification, and, finally, reduced transmission immunity. Using these phases, it is easier to develop a response to the disease and the sequence of interventions (anticipation, early detection, containment, control and mitigation, and elimination or eradication) that then become necessary. 10 World Health Organization, “Emergency Response Framework,” n.d., https://apps.who.int/iris/bitstream/handle/10665/258604/9789241512299eng.pdf;jsessionid=256C1F75F51E56EE2E