Question Three: Read the following article and answer all the questions below: The level of complexity around containing emerging and re-emerging infectious diseases has increased with the ease and increased incidence of global travel, along with greater global social, economic, and political integration. In reference to influenza pandemics, but nonetheless applicable to many communicable and vector-borne diseases, the only certainty is in the growing unpredictability of pandemic-potential infectious disease emergence, origins, characteristics, and the biological pathways through which they propagate. Globalization in trade, increased population mobility, and international travel are seen as some of the main human influences on the emergence, re-emergence, and transmission of infectious diseases in the twenty-first Century. Emerging and re-emerging infectious diseases have presented major challenges for human health in ancient and modern societies alike. The relative rise in infectious disease mortality and shifting patterns of disease emergence, re-emergence, and transmission in the current era has been attributed to increased global connectedness, among other factors. More globalized countries - and, in particular, global cities - are at the heart of human influence on infectious diseases; these modern, densely populated urban centers are highly interconnected with the world economy in terms of social mobility, trade, and international travel .One might assume that given their high susceptibility to infectious diseases, globalized countries would be more willing than less globalized countries to adopt screening, quarantine, travel restriction, and border control measures during times of mass disease outbreaks. However, given their globalized nature, globalized countries are also likely to favor less protectionist policies in general, thus, contradicting the assumption above, perhaps suggesting that counteracting forces are at play: greater social globalization may require faster policy adoption to limit potential virus import and spread through more socially connected populations ,greater economic globalization may indicate slower policy adoption due to legally binding travel and trade agreements/regulations, economic losses, and social issues due to family relations that cross borders . Greater political globalization may indicate greater willingness to learn from others and/or maintain democratic processes of decision making in global coordination efforts, either way potentially delaying the implementation of travel restrictions. Travel restrictions may also have minimal impact in urban centers with dense populations and travel networks .Moreover, the costs of closing are comparatively higher for open countries than for already protective nations. For example, more globalized countries are more likely to incur financial or economic penalties when implementing health policies which aim to improve the health of local populations such as import restrictions or bans on certain food groups/products and product labelling. Globalization, after all, is known to promote growth and does so via a combination of three main globalization dimensions: economic integration (i.e., flow of goods, capital and services, economic information, and market perceptions), social integration (i.e., proliferation of ideas, information, culture, and people), and political integration (i.e., diffusion of governance and participation in international coordination efforts). Globalization appears to improve population health outcomes such as infant mortality rate (IMR) and life expectancy (LE) regardless of a country's level of development (i.e., developed, developing, or underdeveloped) .Links between the dimensions of globalization (i.e., social, political, and economic) and general population health are less clear cut. For less developed countries, the economic dimension of globalization appears to provide the strongest determinant in IMR and LE, whereas for more developed countries, the social aspect of globalization is the strongest factor .This suggests that as a country becomes more economically stable, it then moves towards greater social and political integration into global society; and for less developed countries, increased wealth creation through economic integration potentially delivers the greatest increases in population health. In contrast, for low- to middle-income countries, the social and political dimensions of globalization appear most strongly related to the propensity of women to be overweight .This suggests that for the least developed countries, the adoption of western culture, food habits and lifestyle may be detrimental to adult health if not backed up by social and political progress. Hence, it appears there is no definite relationship between the different aspects of globalization (i.e., social, political, and economic), a country's level of development, and health outcomes that hold across all health contexts. Regardless, trade policies and more generally, globalization, influence both a nation's determinants of health and the options and resources available to its health policymakers. The influence of open trade agreements, policies favoring globalization and greater social connectedness on the (delayed) timing of travel restrictions during a pandemic would make logical sense. Globalized countries are more likely to incur financial, economic, and social penalties by implementing restrictive measures that aim to improve population health outcomes and hence, will be less inclined to do so. Further, countries that rely on international students and tourism and have a high number of expatriates living and working abroad might be even less likely to close their borders or implement travel restrictions to avoid (1) increases in support payments or decreases in tax income during times of unforeseen economic upset, (2) negative backlash from media and in political polls, and (3) tit-for-tat behaviors from major trading partners. However, countries which are more socially connected may also act more quickly because they are inherently at higher risk of local outbreak and hence, to delay local emergence they may implement international travel restrictions earlier. Membership and commitments to international organizations, treaties, and binding trade agreements might also prevent or inhibit them from legally doing so suggesting there are social, trade, and political motivators to maintain 'open' borders. Domestic policies implemented in response to the coronavirus pandemic have ranged from school closures and public event cancellations to full-scale national lockdowns. Previous research has hinted that democratic countries, particularly those with competitive elections, were quicker to close schools. Interestingly, those with high government effectiveness (i.e., those with high-quality public and civil services, policy formulation, and policy implementation) were slower to implement such policies as were the more right-leaning governments .Further, more democratic countries have tended to be more sensitive to the domestic policy decisions of other countries .In particular, government effectiveness - as a proxy of state capacity - can act as a mediator with evidence available that countries with higher effectiveness took longer to implement COVID-19 related response. Countries with higher levels of health care confidence also exhibit slower mobility responses among its citizens. Those results may indicate that there is a stronger perception that a well-functioning state is able to cope with such a crisis as a global pandemic like SARS-CoV-2. More globalized countries may therefore take advantage of a better functioning state; weighing advantages and disadvantages of policies and, consequently, slowing down the implementation of restrictive travel policies to benefit longer from international activities. Regardless, the need to understand the reasons (and potential confounding or mediating factors) behind the selection of some policy instruments and not others and the associated timing of such decisions is warranted to enable the development and implementation of more appropriate policy interventions. The literature seems to agree that greater globalization (and the trade agreements and openness which often come with it) make a country more susceptible to the emergence and spread of infectious and non-communicable diseases. Greater connectedness and integration within a global society naturally increases the interactions between diverse populations and the pathways through which potential pathogens can travel and hence, emerge in a local population. Non-pharmaceutical interventions (e.g., social distancing, city lockdowns, travel restrictions) may serve as control measures when pharmaceutical options (e.g., vaccines) are not yet available However, such non-pharmaceutical measures are often viewed as restrictive in a social, political, and economic context. Our review of the literature did not detect clear indications of the likelihood that globalized cities will implement such measures, nor were we able to identify how quickly such cities will act to minimize community transmission of infectious diseases and the possible mediating effects of government effectiveness in the decision-making process. Furthermore, our review could not locate research on the relative influence of the social, political, and economic dimensions of globalization on the speed of implementing travel restriction policies. The recent COVID-19 pandemic has highlighted the vast differences in approaches to the control and containment of coronavirus across the world and has demonstrated the varied success of such approaches in minimizing the transmission of coronavirus. Restrictive government policies formerly deemed impossible have been implemented within a matter of months across democratic and autocratic governments alike. This presents a unique opportunity to observe and investigate a plethora of human behavior and decision-making processes. We explore the relative weighting of risks and benefits in globalized countries who balance the economic, social, and political benefits of globalization with a higher risk of coronavirus emergence, spread, and extended exposure. Understanding which factors of globalization (i.e., social, economic, or political) have influenced government public health responses (in the form of travel/border restriction policies) during COVID-19 can help identify useful global coordination mechanisms for future pandemics, and also improve the accuracy of disease modelling and forecasting by incorporation into existing models.

A) What would you expect the impact of Covid-19 on the more globalized countries? B) What was the actual response of more globalized countries to the pandemic? C) What was the cost of closing the more globalized countries as a result of Covid-19? D) Why would the more globalized countries be less inclined to implement restrictive measures?