Many major medical tourism source and destination countries are affected by COVID-19. Ian Youngman looks at what this means for medical travel and is pessimistic about the future.
At the time of writing (mid-March), there have been 114,000 confirmed cases, and 4,000 deaths relating to COVID-19. The four biggest countries affected by the virus are China, Italy, Iran and South Korea. Arguably the USA is also a wild card, as real numbers of cases are unknown.
China has one million outbound medical tourists plus a million health tourists, with the three top destination countries of South Korea, Japan and the USA. South Korea gets 350,000 medical tourists per year, with one in three coming from China.
Beyond SE Asia, Iran also gets 350,000 medical tourists, with 90% coming from local countries and the Gulf. This is a region with increased reported of virus numbers.
Italy has only small inbound medical tourism numbers, but over 600,000 health tourism visitors.
The latest IMTJ Global Medical Travel and Tourism Report estimates that inbound medical tourism generates $3.5 billion of revenue for the USA.
The COVID-19 virus impact means that for many medical travel destinations, 2020 is likely to be a year to forget.
Fighting epidemics, or stopping them from spreading, has a cost. When a country is ahead of the spread, the cheap, non-disruptive tools (e.g. vaccines) work. When a country reacts too late or underestimates the problem, then quarantines, movement restrictions and strain on the health-system become more likely, as does the number of infections, with more people seriously ill or dead.
But this can change rapidly, partly depending on speed of response and the attitude of the government. Singapore, for example, seemed like it could succumb to an outbreak because of its close geographic and economic ties to China. China has 3,316 deaths and 80,754 reported COVID-19 cases. A total of only 150 cases since mid-January in Singapore is down to efficient testing, tracking and quarantine.
In Italy, within three weeks, 17 identified cases had rocketed to more than 10,000, with over 460 people dead. Italy was slow to react, and the outbreak went undetected, and there are concerns about hospitals being strained beyond capacity. Italy is now in lockdown for travel in and out and within Italy.
In another leading medical tourism destination, Germany, there are 1,295 cases and two deaths. There are as yet no travel restrictions. Lothar Wieler of the Robert Koch Institute, the leading health and safety advisory body in Germany, has called on the country’s community leaders and hospitals to activate their emergency plans and start preparing for an epidemic.
France, a relatively small European medical tourism destination, is the third most affected by COVID-19, with 1,402 cases and 30 deaths, with schools closed but no travel restrictions.
The UK is another high profile medical tourism destination and has reported 382 cases and six deaths. It has no travel exclusions but there are reports of panic buying and government complacency, with an NHS already stretched beyond normal. The government has so far resisted pleas for travel bans and school closures.
In the USA, experts believe the disease is circulating freely in some places. Reasons for this may include lack of political leadership, budget cuts on preventative services, a failure to accept that the virus is different from a cold, and a failure to test and isolate patients and their contacts. The Centres for Disease Control and Prevention (CDC) has warned that people with underlying health conditions should stock up on prescription medicines. Lack of co-ordinated response by national and state governments, plus a lack of testing kits means that numbers could climb significantly.
CDC advises people at higher risk to avoid long plane rides which, if listened to, will reduce outbound medical tourism.
CDC now admits that most Americans will be exposed to the virus in 2020 or 2021. Official CDC figures are 600 cases and 22 deaths, but many believe this hides the true amount. Up to 10,000 may have already been infected by the COVID-19 coronavirus, according to a new Cedars-Sinai study. The effect in inbound and outbound medical tourism is unknown.
Over 99 countries have confirmed cases while 70 governments have banned travellers from affected regions, barred flights to certain countries and changing visa requirements. The restrictions and virus fears have hit the tourism industry particularly hard.
COVID-19 appears to be deadlier than seasonal influenza, but far less deadly than SARS, MERS or Ebola, with a death rate averaging 3.5% that could drop to 1%. But there is much we do not know about this disease.
People with heart and lung disease or weakened immune systems, as well as infants and older adults, are at higher risk. It is particularly fatal for elderly people and those with pre-existing conditions. Many medical tourists fall into the high-risk categories so are most at risk.
Early indications were that the disease would peak and fall after a few months, affecting tourism and medical tourism.
The American CDC is the first to openly admit that it could last into 2021, and if this is the case the knock-on effect to medical tourism could be significant.
Medical tourism needs to work out how to respond and how to recover when the outbreak ends.
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