Epidemics: How to remain safe?

As the country is pulling all of its resources to stop the disease from spreading, many expats have chosen to leave.

What precautions should expats take in this type of situations? And are cases like these covered by an expat health insurance? This is what we are looking into in this article.

While we live in a world that is much safer than it used to be just several decades ago, disease outbreaks still happen.

Communicable diseases affect large cosmopolitan cities like Hong Kong, countries like Brazil, the UK, China and more. So, if you are an expat living in a country affected by an epidemic — what would be the best course of action? And if the outbreak occurred before a planned relocation, should it be a reason to reconsider?

Naturally, this depends on the severity of the situation — and what potential risks one would be facing by staying in the country or relocating to it. 

There have been several recent cases of disease outbreaks that were considered substantial health threats. These included:

Cholera, a highly infectious disease caused by contaminated food and water, is still a medical problem in a large number of countries. The most recent cholera outbreak was declared by the  World Health Organization (WHO) in the Democratic Republic of Congo (DRC).

Zika Virus has become a rather widespread disease and a cause for concern for  both expatriates and locals. It is not a new disease — Zika was first discovered in Africa in the early 1950s — but the virus has since spread to many of the world's regions including South America, Asia and the USA. The virus is carried by mosquitoes and is especially dangerous for pregnant women as it has been linked to birth defects in children. There is currently no vaccine or effective treatment available for the disease.

Pneumonic plague was declared an outbreak in Madagascar in 2017. The infectious disease is caused by a bacteria that is often found in the fleas of small mammals. People may be infected with the virus through flea butes or direct contact with those already infected.

The outbreaks of Middle East Respiratory Syndrome Coronavirus (or MERS-CoV) have occurred in several of the world's countries including Saudi Arabia, United Arab Emirates and the Republic of Korea. No vaccine or effective treatment is currently available for the disease. The symptoms of MERS include coughing, fever, shortness of breath and other respiratory challenges. The virus is transmitted from close contact from person to person.

Ebola is a form of virus that is rare but severe: the average fatality rate of the disease is around 50%. The vaccines against Ebola are currently under development and have already been used to control the spread of the disease in Guinea and the Democratic Republic of the Congo (DRC). The virus is transmitted via close contact with infected animals and humans.

Avian Influenza (A(H7N9) first started spreading in China in 2013. The outbreak was successfully contained and is no longer considered a health threat. The symptoms of the disease are similar to those of the regular flu but have much more severe consequences. The virus spreads via close contact with birds.

These are just a few of the examples of the recent disease outbreaks — and some of them, like the Ebola virus in the DRC, are still a potent threat.

So, what should one do as an expat in a foreign country suffering from an outbreak of an infectious disease? While every outbreak and situation is different, there are still some general recommendations that would be helpful in most cases. 

How to protect yourself during an outbreak?

Contact your Embassy.

The first thing to do if you find yourself in a situation like this in a foreign country is to contact your Embassy. They should be able to give you updated information about the current situation and its development and provide recommendations on what you can do to stay safe. 

Do research.

Get as much information as you can about the specifics of the outbreak and what precautions are recommended by medical professionals. You can also reach out to the local authorities to inquire about which regions are most affected by the outbreak, if there are plans underway for an evacuation, vaccination,etc.

Avoid contact with the virus.

Where possible, do your best to not come into contact with the potential sources of the virus: whether these are animals or people and avoid travel to the regions that are most affected by the virus.

Practice good hygiene.

While the methods of transmission are different for every disease, practicing good hygiene is essential during an outbreak. Good hygiene practices include washing your hands frequently (with soap or a 60% alcohol-based hand sanitizer), wear a face mask outside (if the disease is airborne) and so on.

Get vaccinated. 

If there are vaccinations available that could protect you from the outbreak, it's best to get vaccinated as soon as possible — and have the members of your family vaccinated as well. 

What about health insurance coverage?

Check your health insurance coverage. Depending on the conditions of your employment contract or the arrangements you've made prior to moving or in your new location, your health insurance may or may not cover relocations in case of an infectious disease outbreak. For instance, during the 2014-2016 West Africa Ebola outbreak, some expat Ebola patients were evacuated to their home countries — and this was covered by their insurance. The thing to check for here is whether your medical insurance covers medical evacuation in case of an emergency. If you are planning to relocate to a country with high risks of an outbreak, it is also best to ensure you have this option in your medical insurance coverage. If you are relocating for employment, make sure to check with your employer if they will be contributing to your medical coverage and whether medical relocation will be covered in the plan proposed by your employer.

Have you ever found yourself in a similar situation while living abroad? What recommendations would you give to fellow expats?