Economic globalization and the COVID-19 pandemic: global ...

1 Economic globalization and the COVID-19 pandemic: global spread and inequalities Jeanne Ludovic1, Sebastien Bourdin1, Fabien Nadou1 and Gabriel Noiret1 1 EM Normandie Business School, 9 rue Claude Bloch, Caen 14000, France. Correspondence to: Sebastien Bourdin (email: (Submitted: 20 April 2020 Published online: 23 April 2020) DISCLAIMER This paper was submitted to the Bulletin of the World Health Organization and was posted to the COVID-19 open site, according to the protocol for public health emergencies for international concern as described in Vasee Moorthy et al. ( ). The information herein is available for unrestricted use, distribution and reproduction in any medium, provided that the original work is properly cited as indicated by the Creative Commons Attribution Intergovernmental Organizations licence (CC BY IGO ).)

2 RECOMMENDED CITATION Ludovic J, Bourdin S, Nadou F & Noiret G. Economic globalization and the COVID-19 pandemic: global spread and inequalities. [Preprint]. Bull World Health Organ. E-pub: 23 April 2020. doi: ABSTRACT Background In just a few weeks, 2019-nCoV has become a global crisis and there is no longer any question of it being a major pandemic. Faced with the spread of the virus and its impact, each country worldwide is dealing more or less urgently with the issue of its public health security. However, the spread of the disease and the speed of transmission need to be squared with the forms and characteristics of Economic globalization , disparities in development between the world s different regions and the highly divergent degree of their interconnectedness.

3 Method: Combining a geographic approach based on mapping the global spread of the virus with the collection of data and socio- Economic variables, we drew up an OLS model to identify the impact of certain socio- Economic factors on the number of cases observed around the world. Results globalization and the geography of Economic relations are the main drivers of the spatial structuring and speed of the international spread of the SARS-CoV-2 virus. While globalization drives the Economic momentum of many regions, it also puts us in danger of numerous negative externalities that are especially apparent during the present COVID-19 pandemic. The extremely rapid spread of the virus across the globe began in the most economically developed regions where international trade and business is prioritized.

4 After initially following the corridors and international trade routes between developed countries, the virus spread later to developing countries. Conclusions The spatial organization of Economic globalization is at the heart of the paradoxes that characterize the COVID-19 pandemic. On the one hand, populations in the most highly developed economies were the first to be affected, which then created a context of uncertainty and aggravated risk for the least developed nations. On the other hand, access to the global healthcare market, which has become even more strained than in the usual context, is a central issue as it is driven by colossal, simultaneous demand with extremely short timeframes in a very large number of countries. Consequently, the timeframe that informs the ramifications of the pandemic is naturally a central issue in the management of any future pandemics with spatial and temporal characteristics similar to those of COVID-19 .

5 Keywords: COVID-19 , Economic geography, world, globalization , spatial diffusion, diffusion pace INTRODUCTION The history of pandemics is a long one, and it is certainly not the first time that an infectious agent has spread across the globe. However, the most recent pandemics in historic terms appear to have been wiped from the collective memory. This helps to explain the apparently widespread impression in the West that the current pandemic is exceptional, leading public and media reports to compare it with the Spanish flu of 1918-1919. Different factors account for the forgotten or otherwise overlooked pandemics: an available vaccination (Grippa A H1N1, 2009), initially linking the disease to what was believed to be a well-defined social group (SIDA, 1981), silent or almost silent media (Hong-Kong Flu in 1968-1970, Asian Flu 1956-1958), inadequate national resources to detect and record cases, the impression of a distant spatial threat (SARS-CoV, 2003) or an anthropological evolution that is often difficult to objectify ( , a shift in the relationship with death and mortality).

6 It is nonetheless understandable that the danger represented by the SARS-COV-2 (WHO, 2020) has been seen as exceptional since, where almost a year was needed for the Spanish Flu to become a global pandemic, only three months was needed for COVID-19 to go global , and only two months for the main centers of globalization to be affected. Indeed, as everyone feared from the moment the virus was first flagged in Wuhan (China) on 31 December 2019, the SARS-CoV-2 virus has now been transmitted worldwide (Al Hasan, 2020). While the global data available suffers from insurmountable problems (disparity in national institutions recording conditions, political agendas, unequal socio- Economic effects in the identification and treatment of cases, etc.), it is nonetheless unquestionable that the virus has now escalated worldwide (Figure 1).

7 By 15 April 2020, 1,914,916 cases had been reported in over 180 countries or territories (194 member states of the WHO), with 123,010 deaths. Figure 1: Number of deaths due to COVID-19 (7 Avril 2020) Several previous studies have used mapping to analyze the spread of epidemics by highlighting spatial patterns . These include tuberculosis (Roth et al., 2016), cholera (Adesina, 1984; Ali et al., 2002), SARS-CoV (Lai et al., 2004; Shannon and Willoughby, 2004; Wang et al., 2008; Meade, 2014), MERS-CoV (Cotten et al., 2014), H1N1 influenza (Smallman-Raynor and Cliff, 2008; Souris et al., 2010), HIV (Wallace and Wallace, 1995; Wood et al., 2000) and dengue (Charette et al., 2017; Acharya et al., 2018; Atique et al., 2018; Zhu et al., 2019). In line with the approach of earlier studies, this paper attempts to analyze how the virus was transmitted across the globe and the underlying causes of its spread.

8 METHOD Mapping epidemics and pandemics is a widely acknowledged method for understanding how they are transmitted and the factors that influence the spread (WHO, 2016). As Koch and Koch (2005) explain, using such techniques helps us to understand how to respond by being more prepared for health crises. Several studies have shown the role of air flows, including that of Bowen and Laroe (2006) who studied the SARS epidemic in 2003 and the Zika epidemic in 2015, both of which mainly affected developing countries (Lourenco et al., 2017). Moreover, in medical geography (Meade, 2014; Dobis, 2020), health infrastructures have also been shown to play a role in the number of cases recorded in the epidemics observed. Finally, in order to understand the extent to which the spread of COVID-19 is due to Economic globalization , we also examine export volumes (in constant dollars) per country.

9 At global level, we only have access to data relative to the number of cases recorded, the number of deaths recorded and the number of recovered cases. We used the official data released by the WHO to inform our study, and we built a linear regression model (OLS) in order to complete our mapping analysis. (World Health Organization) Table 1: Description of variables Variable Date of data Source of data Number of cases on 7/4/2020 7/4/2020 World Health Organization Number of deaths on 7/4/2020 7/4/2020 World Health Organization GDP/capita 2018 World Bank Intensity of commercial exchanges (exports of goods and services in constant dollars) The most recent value between 2016 and 2019 World Bank Number of doctors per 1000 inhabitants The most recent value between 2016 and 2019 World Bank Number of beds per 1000 inhabitants The most recent value between 2016 and 2019 World Bank RESULTS Mapping deaths due to COVID-19 worldwide until 7 Avril 2020 showed that the SARS-CoV-2 virus is active across the globe and, potentially, in all societies and human groups, with the possible exception of the most isolated regions (notably Africa, Asia and Amazonia).

10 The pandemic situation is thus indisputable, with some notable variations. In effect, Figure 1 indicates that on 7 April 2020, the most severely affected regions in the world were the Extreme Orient, Europe and North America, with major infra-regional variations (especially between Western and Eastern Europe, and between the USA and Canada). Given what we now know about the exceptionally high degree of contagion, the average length of the incubation period (5/6 days and up to 14 days) and the very widespread potential of asymptomatic cases (Ren et al., 2020; Wang et al., 2020, Read et al., 2020), the global scale of diffusion makes it particularly challenging to eradicate the virus. This underscores the strategic importance of developing a vaccine in the fight against COVID-19 and the very high likelihood of resurgence.