With Coronavirus having disrupted life as we know it, I had questions which I raise in this short story on humans and modern maladies. "War & Peace in the era of the Coronavirus" is my humble attempt in conducting literature review from sources like WHO, The BMJ, The Lancet etc to put together a brief. It provides the context of the Coronavirus pandemic, mitigation measures, challenges and the way forward.

1. Arsh Singh
War & Peace in the era of
the Coronavirus
A short story on humans and modern maladies

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Health is the
greatest
possession.
Lao Tzu
“
”Founder, Taoism

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Battle casualties since the ‘90s
from 5-10 per 100,000 till the
‘80s is a significant drop.
But is the “Peace Vector” real or
is this just a statistical blip in our
300,000 years of human
history...
~0 per
100,000
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Darfur War
2003
US - Afghanistan War
2001
Iraq War
2003
Kivu Conflict
2004
Syrian Civil War
2011
Yemeni Civil War
2015
Mexican Drug War
2006
Coronavirus
2019
Timeline of major recorded disruptions - 21st Century

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COVID-19
Caused by the virus SARS-CoV-
2, began in Wuhan, China
Pandemic
Exponential rates of growth
results in a pandemic never
seen in our generation
First Death
61-year old with compromised
immunity dies of heart failure
and pneumonia.
Nov
2019
Jan 2020
Almost 0.5
million
affected
(as of March
2020)
What is Coronavirus?
Timeline of Coronavirus
Coronaviruses are a large family of viruses which may cause illness in animals or humans.
COVID-19 is the infectious disease caused by the most recently discovered coronavirus.

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The COVID-19 virus spreads primarily through droplets
of saliva or discharge from the nose when an infected
person coughs or sneezes
The most common symptoms of COVID-19 are fever,
tiredness, and dry cough. Some patients may have
aches and pains, nasal congestion, runny nose, sore
throat or diarrhea with an incubation period of 1-14
days (possibly asymptomatic)
Protect yourself and others from infection by washing
your hands or using an alcohol based
rub frequently and not touching your face.
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What does epidemiological data suggest?
Transmission
Symptoms
Prevention

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Imported Cases People traveling from geos with confirmed cases of Coronavirus
to another country
Local Transmission People who have come in contact with those with a travel
history
Community Transmission Tracing of the virus back to a single origin becomes
impossible
Epidemic Last stage - what China, Italy, Spain among others
are grappling with
How does Coronavirus spread?
Network effects in pandemics

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Health is a state subject ->
central response
mechanisms and
coordination is constrained
Daily wage workers ->
> 90% of India's workforce is
employed in the informal
sector, according to the ILO
(like security guards,
cleaners, streets vendors)
and are being rendered
jobless
High population density
and slums ->
Compounds the problem of
transmission of
Coronavirus, with poor
nutrition and immunity
among children
Lack of proper public
healthcare systems and
insurance ->
With just 70k ICU beds
available in India (and
expected dd to touch 1 mn),
private sector and out of
pocket spending is the norm
(69%)
Challenges in tackling the problem - India

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$5tnG20 nations relief pledge
$9tn
Global travel
industry value hit
$10tn
Capital erased from
US stock market
3.28mn
Record high of US
workers applying for
unemployment
benefits
-10.6% QoQ
Growth
First ever
contraction of
Singapore economy
Global economic impact of Coronavirus (in numbers)
4th biggest impact after WW1, WW2, Great Depression and Great Influenza Epidemic. Important to see it as a health
crisis first, spilling into the economy. Contain the health pandemic first and then economic recovery is possible!

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Identify Weakness
and vulnerabilities the
“enemy” can exploit
Response
“The line between
disorder and order lies in
logistics.”
Recovery
“He who knows these things, and
in fighting puts his knowledge into
practice, will win his battles.”
Learn
“If in training soldiers’ commands
are habitually enforced, the army
will be well-disciplined.”
Workstream for the interspecific war
Invoking the Art of War by China’s own Sun Tzu, the following are key parallel processes required
to fight the Coronavirus
Prior research demonstrates that using
unfamiliar or increasingly complex PPE
increases the risk of self-contamination
Move from PPE “maximalism” to familiar,
well rehearsed-PPE procedures
Standard staffing models with sufficient
training offer sustainable and scalable
medical capacity
Dd of PPE is @100X normal dd levels
with worldwide stock insufficient ->
limited diagnostic testing capacity, esp in
the era of social media and just-in-time
SCM
“Truth decay” or disinformation ->
volatility and panic ->
suboptimal decisions
Build margin and flexibility within HC as
specialized, dedicated teams in an
outbreak, while attractive, could be quickly
overwhelmed at scale -> driving
nosocomial transmission
Localised screening -> syndromic
surveillance + equip HCW for isolation,
triage and care of patients, 2-stage,
preemptive testing in symptomatic elderly
immediately to reduce deaths.
Managed shutdowns in affected regions
to halt transmission with community and
civil collaboration and social distancing
focussed on elderly
Economic stimulus to sustain the
businesses hardest hit by the pandemic
Global cooperation & preparedness to
fight pandemics in future - solidarity
Economic, cultural and social recovery -
across both measured indicators and
intangibles like mental health
Document and investigate deficiencies in
response mechanisms

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Case Study: South Korea vs Italy

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Border ● Effort directed at a global level with pooling of resources
● More porous borders with leadership across geopolitical and economic
dimensions
Int.
Relations
● Global cooperation with solidarity to end crisis
● Political power trailing economic power
Economy ● Global trade flows are at an all time high of $19 tn
● Connected supply chains and with bigger rainy day allocations
Health
Capacity
● Pooling of resources across manpower, knowledge and resources
● Sustained flow to manage peaks and troughs across countries
Social ● More united with honest communication
● People flow continues with capital and goods, social media and
internet transparency with privacy flourishes
What will the new normal look like?
Globalisation Nationalisationor
Borders ● Piecemeal and uneven efforts
● Borders becoming real with US’s lack of global leadership - void
created
Int.
Relations
● International relations will more unidirectional than multidirectional
● Fissures and power vacuums on the global stage, Chinese
investments under BRI increasing whereas US erecting tariffs
Economy ● Fiscal and monetary stimulus disproportionate across regions
● Liquidity pressures with renationalisation of critical industries
Health
Capacity
● Shortage of PPE and HCW
● Localised breakdown of health care systems
Social ● Quicker decisions, more volatility and trust deficit
● Remote working, change in consumer behaviours

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Message from
Central Africa -
“Never this again!!!”
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Thank You

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1. ILO - International Labor Organisation
2. ICU - Intensive Care Unit
3. Dd - Demand
4. Tn - Trillion
5. Mn - Million
6. QoQ - Quarter on Quarter
7. PPE - Personal Protective Equipment
8. HCW - Health Care Worker
9. SCM - Supply Chain Management
10. IMF - International Monetary Fund
Acronyms

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1. https://international.commonwealthfund.org/countries/india/
2. Clinical Infectious Diseases, ciaa229, https://doi.org/10.1093/cid/ciaa229
3. https://www.bmj.com/content/bmj/368/bmj.m543.full.pdf
4. https://www.forbes.com/sites/startswithabang/2020/03/17/why-exponential-growth-is-so-scary-for-the-covid-19-
coronavirus/#251415d44e9b
5. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext
6. WHO
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738307/
8. https://www.wsj.com/articles/g-20-nations-pledge-5-trillion-to-spur-global-economic-recovery-from-coronavirus-
11585258468
9. https://www.wsj.com/articles/will-the-coronavirus-bring-the-end-of-globalization-dont-count-on-it-11584716305
10. https://www.un.org/pga/70/wp-content/uploads/sites/10/2016/01/Conflict-and-violence-in-the-21st-century-Current-
trends-as-observed-in-empirical-research-and-statistics-Mr.-Alexandre-Marc-Chief-Specialist-Fragility-Conflict-and-
Violence-World-Bank-Group.pdf
Bibliography