As I watched the news and got sent videos of countries doing well in the fight against Coronavirus, I thought it might be fun and educative to look into why some countries were doing well and others not so much. Were there best practices we could come up with? I tried covering those countries we hear of most in the news as success stories. Have a read and a think (influence of watching too many British shows I suppose! :-).
Denmark:
As of the writing of this piece, Denmark had almost twice as much testing per capita as the United States and fewer than half as many deaths per capita.
Denmark lowered new infections so successfully that in April it reopened elementary schools and day care centers as well as barber shops and physical therapy centers. Malls and shops were allowed to reopen early May, followed by restaurants and cafes.
Denmark also helped hard-hit companies pay fixed costs like rent — on the condition that they suspend dividends, don’t buy back stock and don’t use foreign havens to evade taxes.
All Danes also enjoy universal medical insurance and paid sick leave. That’s probably a big reason Denmark was more effective than the United States in responding to the crisis. No Dane hesitated to seek treatment because of concerns about medical bills.
Danes pay an extra 19 cents of every dollar in taxes, compared with Americans, but for that they get free health care, free education from kindergarten through college, subsidized high-quality preschool, a very strong social safety net and very low levels of poverty, homelessness, crime and inequality. Can we get there someday? I hope so.
India
India was initially and in some quarters is still hailed as a covid success story. With one of the world’s most concentrated populations per area, India was walking an extremely thin and tight rope. Even while trying to take care of their own domestic conditions, various world leaders were watching. “Would it blow up or would India diffuse the covid bomb?” In the end, as reported in NYT, “India’s lockdown was largely considered effective, and it was widely obeyed.
What was India’s means of keeping covid-19 cases in check? It helps that most Indians do what they are told to by the government. It also helped that most Indians, including my immediate and extended family are shit scared of going to hospitals so would rather stay cooped up at home then risk landing up in a hospital..private or God forbid-public. In conclusion, it is too early to call India’s response a success. Besides making sure the unemployed poor are not ignored, India needs to improve its covid-testing.
I found Ruchir Sharma’s, NYT op-ed, a good take on India’s situation. He mentions”...In its usual way, India was copying measures that rich countries take to protect public safety and welfare but that low-income countries cannot afford. I was in touch with officials in other major emerging countries and none advocated total lockdowns because without the resources to support new armies of the unemployed, closing the economy would only lead to more hunger and death.”
Click here for the most up-to date count of deaths and cases for India.
Taiwan
Taiwan acted fast and that made all the difference. Taiwan is very close to mainland China and was expected to have the second highest number of cases of coronavirus.
The success of Taiwan’s covid-19 response can be attributed to their government, led by President Tsai Ing-wen.
Taiwan’s government learned from its 2003 SARS experience. In 2004, the year after the SARS outbreak, the Taiwan government established the National Health Command Center (NHCC).
In December 2019, on notification from the World Health Organization, Taiwanese officials began to board planes and assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane.
They created 124 new rules to help stop the spread including the following measures:
Stopped all flights to and from China
GPS tracking for quarantined people
Made hoarding and stockpiling illegal
Used technology, including QR code scanning and online reporting of travel history and health symptoms to classify travelers’ infectious risks
Leveraged its national health insurance database and integrated it with its immigration and customs database.
Increased cleaning of public places, transportation modes and, restaurants
Improved resource allocation, including using government funds and military personnel to increase mask production.By January 20, the government had under its control a stockpile of 44 million surgical masks, 1.9 million N95 masks, and 1100 negative-pressure isolation rooms.
Provided food, frequent health checks, and encouragement for those under quarantine.
Reviewed border control from the air and sea
The vice president of Taiwan, a prominent epidemiologist, gave regular public service announcements broadcast made available via the internet.
Thus, proactive case identification, quarantine of suspicious cases, resource allocation, reassurance and education of the public while fighting misinformation, negotiation with other countries and regions, formulation of policies toward schools and childcare, and relief to businesses were all done mindfully and swiftly, the result was there was no lockdown.
The country has 23 million citizens of which there were 441 covid-19 cases as of 5/22/2020 and no more than 7 deaths. Taiwan is an example of how a society can respond quickly to a crisis and protect the interests of its citizens.
New Zealand:
New Zealand’s response has been hailed as probably THE success story on how to manage a pandemic. The country halted the spread of the virus thanks to swift containment measures. Ms. Jacinda Ardern, Prime minister of New Zealand coaxed her “team of five million” into accepting extreme restrictions till they all felt safe.
She took to the national airwaves to explain a four-stage lockdown system that New Zealand would use to confront the health crisis.
In mid-March, as cases were exploding in Italy and Spain, Ardern (1)ordered anyone entering New Zealand into quarantine. A few days later, on March 19, Ardern (2)shut down travel to the country, essentially banning all foreigners from entry.
When the coronavirus hit, (3)she got involved in communication efforts in New Zealand to help explain the virus. Ms Arden strategy: epidemiology brightened with empathy, law leavened with mom jokes has been strikingly effective. The country has very nearly stamped out the virus, exiting isolation with just 21 deaths and a few dozen active cases.
In addition to daily briefings with public health officials, Ms. Ardern also started hosting her own Q&Ans sessions with experts, which she used to target misinformation, and she deployed Facebook Live updates to respond to questions from commenters. (4)She talked about being a team of 5 million and that they all do their part to break the chains of transmission and to eliminate the virus. That was crucial — everybody knowing how they had to behave and that they were behaving for the good of everybody.
As of late May, New Zealand had had roughly 1,500 cases and fewer than two dozen deaths from COVID-19.
South Korea
By the end of February, South Korea had the most COVID-19 patients of any country outside China.
As per this article in the Atlantic about S Korea’s initial success: Just as South Korea appeared to be descending into catastrophe, the country stopped the virus in its tracks. All potential cases were ordered to self-isolate. Within days, thousands of people were tested for the virus. Individuals with the most serious cases were sent to hospitals, while those with milder cases checked into isolation units at converted corporate training facilities. The government used a combination of interviews and cellphone surveillance to track down the recent contacts of new patients and ordered those contacts to self-isolate as well.
Within a month, the Korean outbreak was effectively contained. In the first two weeks of March, new daily cases fell from 800 to fewer than 100.
This is in stark contrast to how the USA handled its initial cases which at the end of February were less than 10 but by the end of May quickly escalated to 100,000!!! Why? How?
The two key reasons for South Korea’s success in dealing with the virus, apart from proper and timely use of smartphone technology for contact tracing, are a culture of docile collectivism (similar to what I noted for India) and the fact that they had gone through a similar suffering (and learned from it!) when the SARS, MERS and H1N1 viruses hit them on separate occasions a few years back. In response to those viruses, South Korea rewrote much of its infectious-disease-prevention legislation including giving laboratories the green light to use unapproved diagnostic kits during a public-health emergency and health authorities warrantless access to CCTV footage and the geolocation data from the new patients’ phones.
As of June 20th, the country has confirmed 12,373 cases, including 280 deaths. As reported by Time magazine, “South Korea has been struggling to contain a spike in virus transmissions since early May, when it eased social distancing rules. Most of the new cases have been reported in the densely populated Seoul metropolitan area, where about half of the country’s 51 million people live.”
The new cases have been linked to nightlife establishments, church services, a big e-commerce warehouse and door-to-door salespeople.
HongKong:
They have had a few 2 weeks period- one full quarantine period-with no new locally transmitted cases of covid-19.
They didn’t do a full lockdown. Schools, gyms, and some government offices did close but restaurants, shops, and public transport remained open. Success is attributed to the resident's willingness to be vigilant about wearing masks, comply with contact tracing and self quarantine after testing positive. Since Jan 22nd, their death is 4 and the number of cases is 1040. They are now open to essential visitors from China as well.
I conclude this article now getting a better sense of what was common amongst the countries who had a successful response to covid-19. My concussions are:
They were relatively small (such as New Zealand, Denmark) so could make most citizens agree to a common approach and need to fight the virus
They took the virus seriously and didn’t just wish it away or ignore it, no matter how invisible it is or mercurial it is on who it attacks and who recovers from it. Swift and effective action from the central government was the success mantra.
They were led by amazing leaders and yes, in most cases the leaders happened to be women. Iceland, Germany, Finland, Norway are all additional countries that had extremely low levels of covid19 AND had women prime-minister or presidents.
They had suffered something similar (as in the case of Hong Kong, South Korea) so were quicker in gearing up to react vs. acknowledge.
They had good health insurance or were offered better health insurance in light of covid-19 to make their citizens feel like they had a safety net.
Hope by the time this blog gets around, all countries will be on a declining trajectory concerning the negative impact of this virus. We can hope and pray AND most importantly act!