International Reactions to COVID-19

The recent outbreak of the 2019 novel coronavirus in China, which was tentatively named 2019-nCoV, and now officially declared as COVID-19 by the World Health Organization (WHO), [1] has caused a lot of panic around the world and forced nations to react with extreme measures. Whereas some of these reactions sought to support China, which is the central source of the outbreak, most of the reactions were meant to protect the international community from the risk of exposure to the fast-spreading infection. This commentary reviews the reactions from many countries across the globe, with regards to international supports rendered to China, closure of borders and visa restrictions, and expat evacuation and quarantining.


Introduction
The recent outbreak of the 2019 novel coronavirus in China, which was tentatively named 2019-nCoV, and now officially declared as COVID-19 by the World Health Organization (WHO), [1] has caused a lot of panic around the world and forced nations to react with extreme measures. Whereas some of these reactions sought to support China, which is the central source of the outbreak, most of the reactions were meant to protect the international community from the risk of exposure to the fast-spreading infection. This commentary reviews the reactions from many countries across the globe, with regards to international supports rendered to China, closure of borders and visa restrictions, and expat evacuation and quarantining.

Supports from the Global Community
Many nations have rendered their support to China in diverse ways, spanning donations to vaccine developments. One of such nations is Malaysia. The Malaysian NGO OPS Harapan donated a total of 2.4 tons of medical supplies to Wuhan to fight the outbreak. These items, as noted by the founder of the NGO, Ng Yeen Seen, comprise of 338,000 surgical masks valued at RM338,000; 540 N95 face masks worth RM4,320; 107,900 rubber gloves valued at RM32,370; as well as 876 safety goggles worth RM34,922 [2]. Being the world's largest producer of medical gloves, the nation equally donated 18 million pieces of medical gloves to medical authorities in Wuhan. This donation was made when Malaysian officials went to evacuate their citizens from the epicenter of the outbreak [3]. To help in curbing the novel coronavirus along with other contagious diseases in Malaysia, MR DIY has also distributed 3.5 million free face masks nationwide [4]. Aside Malaysia, the United States has also announced its readiness to spend up to $100 million in aid to China and other nations affected by the virus. The deputy secretary of state, Stephen Biegun, also revealed that the US has already sent nearly 17.8 tons of medical supplies to China. The supplies are believed to include masks, gowns and other protective clothing [5]. Additionally, the White House top economic advisor, Larry Kudlow, also reported that the country has arrived at a decision to deploy a team of experts from the US Centers for Disease Control and Prevention to help the Chinese government in overcoming the viral infection [6]. The nation's pharmaceutical company, Gilead Sciences Incorporation, has also developed the antiviral drug remdesivir which is currently in use in China to treat COVID-19. Chines drug makers are expected to begin mass production of the antiviral drug to fight the disease [7]. The American business magnate and philanthropist, Bill Gates, and his wife, who founded the Bill & Melinda Gates Foundation, has also pledged to donate up to $100 million to combat the outbreak. The money is meant to improve detection, isolation and treatment efforts; protect at-risk populations in Africa and South Asia; and accelerate the development of vaccines, drugs and diagnosis [8].

Journal of Clinical and Medical Research
In attempts to speed up the development of proven vaccines against the 2019-nCoV, the Norway-based Coalition for Epidemic Preparedness Innovations (CEPI) has disclosed funding for three respective projects with Inovio, the University of Queensland and Moderna [9]. The organization has also announced its partnership with Glaxo Smith Kline (GSK) to aid the vaccine development against the fatal disease. In support of the CEPI projects, the government of UK has committed £20 million additional funding to help the financing of the vaccine production [10]. Similarly, the European Union has also mobilized a sum of €10 million in aid of research projects that seek to understand the epidemic and contribute to a more efficient clinical management of patients [11]. Meanwhile, WHO has announced a $675 million preparedness and response plan through April 2020 to further curb the virus' spread and to help countries with inadequate health systems? The organization is also set to send an international team of specialists to China to investigate the outbreak, and device the quickest means of containing the disease. In addition to WHO, the United Nations International Children's Emergency Fund has also contributed materials ranging from medicine to face masks, protective suits, gloves, and disinfectants to alleviate shortages in China [12].

Closure of Borders and Visa Restrictions
Since the COVID-19 has been detected to have high pandemic potentials, several countries have imposed travel restrictions on Chinese nationals and other expats who have history of visiting Wuhan and China at the time of the emergence of the outbreak. Aside cancelling flights to and from China, some of these nations have closed their borders to Chinese citizens, and also banned travel visas to Chinese nationals. To a larger extent, some countries have even closed their borders to everyone travelling from an Asian country with a record of the infection. Whereas these bans are meant to be temporary, most of the countries intend to keep the bans in place until the outbreak is fully contained and dealt with. Despite being China's special administrative region, Taiwan has announced the temporary closure of its borders to citizens from mainland China, Hong Kong and Macau. The decision, announced by the Central Epidemic Command Center (CECC) on Monday February 10, is part of the state's efforts to limit the spread of the new virus. However, the CECC noted that the ban will not apply to people on business contracts, international workers transferred to Taiwan, and holders of Taiwan resident permits, alongside their spouses and minor children [13,14]. Moreover, Hong Kong has also closed 13 borders crossings with mainland China, and announced the suspension of all ferries and rail services from 6 th of February. The state has equally reduced all incoming flights from China by 50%. That notwithstanding, medical workers of Hong Kong were reported to have embarked on a strike asking the government to close all borders to mainland China. It is however not certain if Prime Minister Carrie Lam will grant their request [15]. Aside Taiwan and Hong Kong, several other Asian countries and beyond have imposed some forms of restrictions on China (Table 1) [16,17]. Most of these nations are shown on (Table 1). Whereas almost all the countries impose bans on China only, Papua New Guinea has announced shutting its air and seaports to all expats from Asia. The country has equally suspended its visa program to Asians [18]. Similarly, the Royal Caribbean ship has banned all guests with Chinese, Hong Kong, and Macau passports [19].

Evacuation, Screening and Quarantining
Apart from cancelling flights to and from China, many countries have equally evacuated their citizens from Wuhan. Almost all of these countries have resorted to isolating the evacuees from the public for a minimum of 14 days. This would allow health specialists to monitor and test the evacuees for the novel coronavirus over the quarantine period. As an added measure, all nations across the world are screening passengers from China at various ports to ensure anyone with symptoms of fever and cough could be quickly quarantined and tested for the COVID-19. Most of the countries which have evacuated their citizens from Wuhan, and a few of them who are still in the process, are presented in Table 2 [20,21]. Whiles appropriate measures need to be taken to avoid infected nationals from traveling across the borders of the country; it is unfair for the international community to block even healthy citizens of China from returning to their employments in foreign countries. This will further weaken the financial standings of the citizens and prolong the economic effects of the outbreak, not only on China, but the world. International ties with China could also be