GIS and Earth Observation University

History shows that pandemic outbreaks cause economic, political and social disorders with significant mortality and morbidity on the human side. Since 2005, the WHO have reformed the International  Health Regulations (IHR), which entered into force on June 15, 2007, as a response to the 2003 Severe Acute Respiratory Syndrome (SARS) pandemic failure in early reporting the outbreak. The amended international instrument binding 194 countries impose a framework aiming to maintain a global public health security. The IHR established rules and procedures compels states’ parties to uphold global disease management standards to detect, report and respond to outbreaks. The pandemic outbreaks in the years that followed have induced more stakeholders to step in and invest in more sophisticated disease preparedness tools, cooperation means and risk mitigation to contain the pandemics[1]. The use of Satellite technologies by the international community presents an integral part in the management of pandemics, which was evidenced in the case of the Ebola Virus Disease spread in West Africa between 2013 and 2015. The “US Geological Survey”, on behalf of the “US National Geospatial-Intelligence Agency” activated in 2014  the “International Charter on Space and Major Disasters” to enable the use of satellite technologies for the monitoring and rapid response to mitigate the risk of the Ebola outbreak in “Sierra Leone”. Consequently, a pandemic outbreak was categorized as a disaster under the Charter for the first time[2]. The international instrument enabled a worldwide collaboration through, which countries availed themselves free access to satellites output in response to pandemic outbreaks. After the West Africa Ebola’s outbreak, the international community has witnessed the emergence of new trends of cooperation to contain the pandemic spread, which was catalyzed by the rise of “New Space”. The technological progress, space financial funding growth, globalization, and digitalization have led to the emergence of “New Space”[3]. The latter gave birth to “New Space” firms which consist of (1) "Space access" firms specialized in payload launch into space (cargo and human), (2) "Remote Sensing" firms, (3) "Satellite Data and Analytics" firms, (4) "Habitats and Space Station" firms, (5) "Low Earth Orbit Tourism", and (6) "Beyond Low Earth Orbit" firms and "Research” and Investment" Firms. [4]. Thus, the emerging new trends in the space industry marked an unprecedented development led by private actors. The global space sector, in the last five years, has undergone remarkable growth in the launch service and ground equipment activities,[5] which was catalyzed by the private actors’ entry into the global space economy[6]. “New Space” induced private actors to develop breakthrough technologies to reduce satellites’ manufacturing and launching costs, evidenced in the bourgeoning SmallSats and constellations business. The witnessed shift within the satellite industry amidst the “New Space” rise, led national and international agencies to partner with commercial space firms to use their satellite capabilities like remote sensing capacities to access high-resolution satellite imagery. Such a partnership was critical in enabling stakeholders’ use of satellite technologies during the previously discussed Ebola outbreak for more effective mapping as the available maps of that region were made since the colonial era[7]. For example, the known commercial company for its humanitarian mapping services, “Mapbox” has enabled responders like “Doctors without borders” a “crowdsourced tracing” capabilities to access helpful data information filling the “two generations-old” map gaps[8]. The Ebola outbreak has marked a shift in the reliance on satellite imagery mapping to manage risks from being in the hands of states actors to be shared with private actors. Consequently, the involvement of private actors helped in the capacity building as well as the allocation of maximum resources under the management and control of both the competent authorities and international stakeholders. Furthermore, Satellites’ Global Positioning System (GPS) services helped healthcare professional during the Ebola outbreak to keep track of the exact outbreak zones and to find their way around in unfamiliar areas[9]. Schootman et al. emphasized the strategic role of unmanned aerial vehicles, location-based social media platforms and other GPS applications in the surveillance, monitoring, and mitigating public health risks[10]. As for Telemedicine services deployment in the Ebola case, it has offered real-time results, which enabled those who are fearful of entering into “Ebola” military-alike facilities to be tested home[11]. 

In the case of Covid-19 outbreak in China, the country has witnessed an unprecedented rush to use Telemedicine services provided by the private health sector. As per the Economist (2020), there was a shift in the consumer behavior toward the use of Telemedicine, which catalyzed the development rate of the private “online healthcare market” that would have taken five years without the pandemic outbreak. Taking the example of “JD Health” the private online healthcare firm, its founder “Xin Lijun” claimed that his monthly services have tenfold increased since the outbreak. Notwithstanding the private Telemedicine assistance during the pick of the outbreak, private health providers are challenged due to medicine deliveries issues and to the Chinese health authorities’ restrictions like limiting the permission for online practitioners to only prescribe repeated medications as well as follow up consultations[12]. Furthermore, the Chinese health authorities, with the cooperation of the “China Aerospace Science and Industry Corporation” have utilized Telemedicine services into remote areas in Wuhan and Shantou. “Telemedicine Vehicles” and remote technicians were connected to local hospitals through ICT to conduct the needed tests on the residents who received remote medical assistance in case of a positive result to Covid-19. Telemedicine services played an important role to facilitate the collaboration between healthcare centres to deliver adequate and timely response whereby real-time imagery of patients is collected, transmitted through a satellite moderator and processed to the communication satellite platform, which is sent back to the control centre[13]. The use of satellite technologies, in this case, allowed healthcare providers to remotely follow up with the patients as well as provide training, mentorship and supervision to other healthcare employees. Most importantly, these remote services enabled healthcare employees to conduct their missions with minimum contact with potentially infected patients. Nevertheless, due to the high number of the infected patients who needed hospitalization, the Chinese authority sought to expend the healthcare facilities by building two hospitals “Huoshenshan” (25,000 square meters) and “Leishenshan” (30,000 square meters) in Wuhan, which were both completed in ten days. Such an accomplishment could be made possible, in a pandemic zone, only through robust monitoring from the stakeholders via the high-resolution observation ”GaoFen” satellites constellation. The healthcare facilities’ project was achieved under Wuhan University who relied on satellite services for the mapping, surveillance,  and remote sensing to complete the mission[14]. China has deployed the satellite capabilities with complex, disruptive technologies to mitigate its distressed healthcare system and contain the dissemination of the virus. Robots and Internet of Things (IoT) devices, which consist of any device that includes a sensor used to transmit data via the internet, served to reduce the contact between health service providers and contaminated patients in Wuhan. For example, the latter’s “Hongshan   Sports Centre” was turned into a smart field hospital accepting patients. The smart hospital was handled under the collaborative efforts between “China Mobile” Company, “Wuhan Wuchang Hospital” and “CloudMinds” the cloud-based systems for robotics maker. Thanks to the IoT devices and robots, the exhausted healthcare providers were relieved from working around the clock. They were kept safe from potential contamination and thus, the infection did not spread to the medical teams who are considered to be the most valuable asset during a pandemic. Furthermore, for efficient monitoring from a distance, a specific protocol was designed relying on satellite technologies. The smart hospital was monitored at a distance, starting with the “triage” through initial screening of the patient by 5G thermometers to detect signs of fever, followed by monitoring his vital signs through a worn ring or bracelet connected with the “CloudMinds” Artificial intelligence platform[15]. The abovementioned non-exhaustive means, supported by satellite technologies,  have been crucial for China to contain the fast-spreading Covid-19. Thus, the combination of Telemedicine, which primarily hinges on the deployment of satellite technologies’ use, Artificial Intelligence and other exponential technologies made a great contribution to the Chinese healthcare provision during this public health crisis. Nonetheless, these tools and methods could not be as efficient without taking timely measures by the competent authorities to contain the pandemic and prevent its spread outside of the outbreak areas. The scale of the applied measures was boldly rising in accordance with the spread of the virus. It was escalating from imposing schools and workplace closure to mandatory quarantine and total lockdown in Wuhan and other affected cities. The Chinese authority used surveillance technologies to implement its strict public policies for the general interest. It deployed all its surveillance resources as drones and location-based social media applications to track people’s movements. After weeks of struggle against the virus, China has considerably reduced the rate of transmission of infection[16]. The example of China could be a model (which could always be improved) on how to ensure the achievement of the obtained results to be applied for the future. However, the application of the Chinese model may be possible only if the country had adequate human capacities as well as robust technological, infrastructural, financial and timely preparedness capabilities and strong law enforcement mechanisms. These capabilities may be considered to be essential and indivisible determinants to contain rapid virus dissemination successfully. Having said that, one would imagine the challenging situation if the pandemic outbreak occurred in low resource developing countries, which lacked trained healthcare providers to manage pandemics as well as the technological, financial and infrastructural capabilities. One would question the reliance on the international community aid and cooperation to cover larger-scale outbreak. In such a situation, the international community would be challenged to face a global health crisis with an overwhelming call for action in different regions across the world. However, the situation is compelling even in the case of a developed country, taking the example of Italy who is currently driving its fierce battle against Covid-19, the latter’s healthcare system is near a collapsing stage. The situation in Italy has exposed many gaps in its healthcare system. The shortage of healthcare providers, which was aggravated by the spread of the virus among doctors and nurses, as well as the shortage of Intensive Care Units and medical equipment, have caused major distress within the system. As a consequence to the stated facts, the death toll in Italy has considerably jumped as one of the nurses from “Mergamo” Italy claimed: “I have never seen so many people die together before my eyes," said a nurse from one of the main hospitals in Bergamo, a city in northern Italy”[17].

The difference between the Chinese and Italian healthcare capabilities reflects the respective outputs putting forward the hypothesis that a similar reliance on the Chinese deployed resources and the taken actions to manage the pandemic would have made a difference in Italy. Nonetheless, the hypothesis cannot be ascertained due to lack of facts and reliable information, mainly concerning the Italian case. However, based on the Chinese experience with Covid-19, the key to address and manage the outbreak hinges on abiding by the International Health Regulations, timely detecting the infection before it spreads at a large-scale, mobilizing the needed resources, appointing trained healthcare providers to carry on the field and Telemedicine services, tracing infected patients contacts, quarantining and isolating, preparedness measures including mandatory lockdowns and international coordination.

[12] The Economist, Millions of Chinese, cooped up and anxious, turn to online doctors, March 5, 2020.
<https://www.economist.com/business/2020/03/05/millions-of-chinese-cooped-up-and-anxious-turn-to-online-doctors>. (Accessed on March 21, 2020).

[13] Yuan, Yue, How Space Technologies Help Fight The Coronavirus In China (Part 2), Spacewatch Asia Pacific Business Intelligence about Space Activities, 2020. <https://spacewatch.global/2020/03/spacewatch-gl-op-ed-how-space-technologies-help-fight-the-coronavirus-in-china-2/>. (Accessed on March 21, 2020). 

[14] Yuan, Yue, How Space Technologies Help Fight The Coronavirus In China (Part 2), Spacewatch Asia Pacific Business Intelligence about Space Activities, 2020. <https://spacewatch.global/2020/03/spacewatch-gl-op-ed-how-space-technologies-help-fight-the-coronavirus-in-china-2/>. (Accessed on March 21, 2020).

[15] Hornyak, Tim, What America can learn from China’s use of robots and telemedicine to combat the coronavirus, CNBC Markets, MAR 18 2020. <https://www.cnbc.com/2020/03/18/how-china-is-using-robots-and-telemedicine-to-combat-the-coronavirus.html>. (Accessed on March 21, 2020). 

[16] Fleming Sean, China's response shows how bold decision-making can contain coronavirus, World Economic Forum, March 11, 2020. <https://www.weforum.org/agenda/2020/03/chinas-response-shows-how-bold-decision-making-can-contain-coronavirus/>. (Accessed on March 21, 2020).

[17] Chow, Denise, Emmanuella Saliba, Italy has a world-class health system. The coronavirus has pushed it to the breaking point, CNBC, March 19, 2020. <https://www.nbcnews.com/health/health-news/italy-has-world-class-health-system-coronavirus-has-pushed-it-n1162786>. (Accessed on March 21, 2020).