The Wider Impacts of MERS

June 22, 2015

Since 2012, 1,321 cases and 466 deaths associated with Middle East Respiratory Syndrome (MERS) have been reported, mainly in Saudi Arabia. But little attention was paid due to the disease's low transmission between humans and relatively low case counts.

On May 4, MERS made its way to South Korea via a 68-year-old man who had recently traveled to the Middle East. With today's ease of international travel, it's not surprising that MERS has been diagnosed beyond Saudi Arabia and the United Arab Emirates, but other instances of international spread have led to few or no additional cases.

The difference here is that with 172 confirmed cases and 27 related deaths in South Korea (as of June 22, 2015), the MERS outbreak in South Korea is the largest to date outside of Saudi Arabia. Officials at the World Health Organization (WHO) are citing four primary problems that may have led to increased spread in South Korea:

  • Doctors in the region had never seen MERS before
  • ERs are typically overcrowded
  • Patients travel to multiple hospitals to shop for care
  • Hospital rooms are packed with visitors who often perform nursing roles such as changing bedpans and feeding patients

These factors may have contributed to the fact that all of the cases in South Korea have been linked directly, or indirectly, to the initial patient, who was seen at three different hospitals.Because of the limited disease spread outside hospitals and the decrease in transmission rate after interventions, the WHO has determined that this event does not constitute a Public Health Emergency of International Concern.

As of June 22, 4,035 individuals in and around Seoul are under quarantine, and at least 9,331 more have completed quarantine.Quarantine measures, under which healthy persons are monitored for MERS symptoms, can have a serious impact on local economies.

Consider that for every reported infection, nearly 80 individuals have been quarantined on average. Schools,universities, and businesses have closed due to the lack of customers or available workers. In addition, many healthcare workers-who are at an increased risk for MERS-have been quarantined after coming into contact with MERS cases, limiting response capabilities and hospital productivity.

Insurance lines that may be affected by this outbreak include health and life, workers' compensation, business interruption, and event cancellation insurance. On top of these sectors, it is important to monitor travel-related insurance during an outbreak of any size. The Korean Tourism Organization has reported that more than 100,000 tourists have already canceled their travel plans to the region due to this outbreak. The governments in neighboring regions issued alerts suggesting citizens avoid nonessential travel, although travel advisories have not been issued by the WHO.

Some event-specific insurance policies have been created to mitigate risk associated with MERS. For example, the Korean Ministry of Culture and Tourism is providing free insurance that disburses funds if a visitor contracts MERS. In China, where only one case of MERS has been diagnosed, individuals can purchase similar coverage from participating insurance groups. It will be interesting to see the popularity and utility of these plans as the event unfolds.

The current situation is reminiscent of the Severe Acute Respiratory Syndrome (SARS) outbreak of 2003, which was caused by a related coronavirus. After killing at least 800 people and infecting more than 8,000, the final global economic loss was estimated between USD 15 and 20 billion, demonstrating that potential losses associated with small infectious disease events can be surprisingly large.

Read more about modeling emerging diseases.

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