Covid-19 - The case of different countries

Supratik Mitra | Updated: April 02, 2020, 6:55 IST

How different countries dealt with Coronavirus.

After seeing a many-fold increase in cases of the COVID-19 or Coronavirus worldwide from late February to early March, WHO chief Dr. Tedros Adhanom Ghebreyesus declared the virus a pandemic on March 11th, 2020, intimating the world about an impending global crisis.

Presently, the total number of reported cases of COVID-19 is about to reach a million, accounting for more than 47,000 deaths. Although the mortality rate from COVID-19 is on the lower side when compared with past pandemics, the major concern that many experts share is the exponential rate at which it is increasing. The world is at a race against the virus, and what the administrations of different countries are doing to curb the spread of the virus will have a long term impact on the world. 

In the fight against Coronavirus, different countries are at different stages and have implemented various kinds of policies to flatten the curve. In the current scenario, where a working vaccine has not been developed, minimizing the effect of the virus seems to be the only option. Considering every country has different demographic, socio-political, and economic conditions, a one-size-fits-all method will not do any good, therefore let us look at how some countries around the world have approached the issue.

CHINA

China had its disadvantages in being the starting point of the pandemic, so for countries following, it is important to study the Chinese outbreak. Probably the biggest criticism the Chinese Government has faced is of blinding the world and even their citizens of information from early whistleblowers.

Eight doctors in Wuhan, after noticing a patient with a Pneumonia that was not being cured with normal treatment, discovered this novel strain of the virus and published a report in early December 2019. The reaction of the Chinese Communist Democratic Party, however, was rather authoritative, as it effectively silenced the threat, and tried to paint a picture of normalcy. When in January the virus made headlines, President Xi Jinping called for resolute efforts and drastically came down with policies to stop further spread.

Wuhan went on a complete lockdown on January 23rd. Similar restrictions were imposed on 15 other cities in Hubei province, locking down and restricting the movement of more than 60 million people to avoid community transmission. Fighting the virus became a national priority, and the Government reallocated a huge chunk of the country’s health care system to fight the battle against the virus. More than 20,000 medics flew from various parts of the country to Wuhan and other cities of Hubei. The Government specifically built new facilities for patients and not only addressed the problem of shortage of beds, but also isolated patients of coronavirus from other patients.

Testing, which has been a point of difference for many countries in how it is done or rather how much it is done, was made free for anyone who showed symptoms of the infection. Although these methods were effective, with WHO declaring the Chinese policies to be a model for others, they also faced criticism. People have criticized the Chinese lockdown to be rather draconian with party members forcing people to be inside, as reports came out which claimed that people were not able to even get basic necessities for survival.

The questions here are whether a lockdown with violation of human rights is the right thing to do? Is it actually possible in other liberal democratic countries? Yet the world has something to learn from the expedited way in which the Chinese administration has operated, as time is of the essence in this fight.

ITALY

It was only astonishing to see a country with world-class medical facilities crumble in a matter of a few weeks when the virus hit Italy. The health care units, simply put, were overburdened with the number of patients testing positive and showing symptoms. The country has now over 10,000 deaths, out of the more than 1.1 lakh infected people, due to the virus, and a significant reason for it can be linked to the late implementation of policies like the lockdown and social distancing.

One of the major problems that Italy faced was scepticism of recognising the impending crisis. The systematic inability of leaders to listen to experts was highlighted in this case. In dire conditions, it is common among politicians and even with general people to listen to their inner circle, but in such a situation of uncertainty, it is important to overlook that temptation and absorb the knowledge within the pockets of expertise.

Another important lesson that one can learn is to avoid partial solutions. The Italian Government started with locking down only a small portion of the country and then gradually issued multiple decrees to increase the lockdown area until it applied to the entire country. Although in normal times it can be an apt solution, in a case where one does not know what will happen in the next few days, such a solution facilitated the spread.

Italy, rather than following a preventive procedure, followed the virus. As Northern Italy was put under lockdown, there was a mass exodus of people to Southern Italy which brought the virus to places it was not present before. The lack of coherent procedures to stop the chain of transmission led to a flash flood of patients, drowning the health care system, leading to deaths and a crisis that could have been prevented. Apart from the administrative failure, experts also point to the demographic makeup of the Italian population. With the second-largest percentage of people over the age of 65, the population was more perceptible to critical cases, further causing the curve to rise rather vertically.

SOUTH KOREA 

As of 2nd April, with close to 10,000 cases, South Korea is one of the top 15 countries for the total number of cases. Health experts point to an important fact in the Korean data i.e. the country has been able to reduce the number of new cases and effectively flatten the curve, which something that even developed countries of Europe and America have failed to do.

So, it becomes important to study how this massive task was achieved by the Korean administration, and that too without locking down entire cities.

One very important reason Korea was able to swiftly roll out policies to curb the spread was its preparedness. It made sure they had enough ventilators, health care professionals, masks, and other necessary items that are required to control and treat positive cases. This level of preparedness gave them a head start, which other countries did not have because of negligence.

Social distancing as a principal was widely propagated by various modems, with the Government issuing daily press releases and automated messages. Transparent information also helped, with the Government assessing possible infected places and publishing lists, which allowed the citizen to take calculative measures.

Mass testing has also been key in reducing the number of daily cases. Innovative testing measures like drive-through tests encouraged people to get tested and allowed the Government to see their target. This recognition of target allowed to dispense needed facilities wherever required.

Contact tracing was also introduced, in which officials through the use technologies were able to see if people were flouting quarantine regulation. If a patient tested positive moved around, people within the area who might have contacted the individual were alerted via message. These swift and early actions go to further prove the importance of speed in the fight against the virus. 

USA

As the propaganda war continues between the USA and China, China can’t wholly be held responsible for the spread of the virus in the USA. It cannot cover up the mistakes that the Trump administration has made. Latency seems to be a deep pit, from which it can be difficult to come out of, and America seems to have fallen into that pit, because of several reasons which point toward negligent governance.

The American citizens were left blind to the scale of the looming medical catastrophe that has now taken place, because of an administration which tried to paint the picture of normalcy in the country and now is struggling to stand back up. The country lost a whole month according to leading epidemiologists, as there was a lack of a robust system of testing. When in February the problem was realised by the Government, the Centers for Disease Control and Prevention (CDC) took another two weeks to fix the test. Yet they continued to follow the policy of restrictive testing. This restricted community surveillance and identification of early local hotspot which could have been quarantined to limit the mass spread of the virus. While at the start of this lost month, when the Government could have rallied for the effective working of organisations and agencies responsible, the President was dismissive of the threat to public health and the economy. He went on record to say, “It (Coronavirus) is going to disappear. One day — it’s like a miracle — it will disappear.” 

By early March, when the Federal Government finally decided to expand testing, it was too late. With early lapses, containment was not an option, rather the mitigation of harm is what America could hope for. Now the number of cases has risen to more than 2,00,000, which is the highest in any country.

Due to existing intensive care facilities, the mortality rate is low. The economy is stuttering and everyday life, in most parts of the country, has come to a halt. It is interesting to see how one of the world’s richest countries, with the most highly trained scientists and infectious disease specialists, gave away their chance in containing the virus, because of bureaucratic inefficiency and lack of leadership at multiple levels. 

JAPAN 

Japan was one of the first countries to be hit by the coronavirus outside of China, yet in recent data, it is one of the least affected countries among the developed nations with a little over 2300 cases. It is puzzling health experts.

The looming question is has Japan dodged a bullet or is it about to be hit? The Government contends that it has been aggressive in identifying clusters and containing the spread which makes the overall per capita infection low. Government suggests over 80% of the positively tested patient were restricted from spreading the virus.

Although schools were closed, normal life in Japan has continued. Tokyo rush-hour trains remain packed and restaurants remain packed, but experts have criticized the fact that Japan has tested a limited number of patients.

Kenji Shibuya, a professor of King’s College London and former chief of health policy at the WHO, sees two possibilities on where Japan was able to contain the virus; by focusing on outbreak clusters, or that there are outbreaks yet to be found, and according to him both are possibilities. 

The proximity of Japan to China might have helped Japan to raise alarms in the early stages of the countries outbreak. Secondly, Japan also might have some in-built advantages, such as cultures where handshakes and hugs are less common than other countries. It also has the rates of hand-washing above those of Europe. Cases of seasonal flu and influenza have also been in decline for seven straight weeks which might suggest that the Japanese have taken to heart some basic steps to stop infectious diseases.

Japan, even after increasing testing capacity, has been using only 5% of it. Japan has tested about 15,000 people and has an infection rate of 5.6%, compared to 18% in Italy. Japanese officials seem to be very confident with their testing mechanism, yet experts think it can later cause a problem for Japan.

Should Japan see a jump in, it is better prepared than many peers. It has 13 hospital beds per 1000 people, which is the highest among G-7 countries and more than triple than that of Italy, the USA, and the U.K, according to World Bank data. With Prime Minister Abe, promising to do everything to end the coronavirus outbreak, there continue to be a suspicion among health experts that there lies an impending outbreak of the virus in Japan behind the veil of promising data.

INDIA

As India reaches 2000 positive cases, it has already implemented a nationwide lockdown. 

(Read India's case in more detail) 

Demographic attributes seem to be a huge disadvantage for India in fighting against a virus that takes no time to transmit, so the lockdown can be an effective way of breaking that chain.

Another point for which the Government has been applauded is the early screening facilities for people travelling from affected countries. One major question that is being asked is, why is India, with a population of more than a billion, testing so less? As seen in Italy, USA, and even China to an extent, low testing can be linked to an exponential rise in the number of cases in the coming stages. 

In India, testing has been largely restricted to people with travel history or people who have known individuals in their close family circle with travel history.

Private modes of testing have been expensive which is not conducive for a poor country like India. India has some of the lowest numbers of tests conducted for every million people, compared to other countries. This can prove detrimental as India enters some of the crucial weeks in the fight against the virus.

With the lack of mass testing data, it also becomes difficult to assess the target groups and areas which delays the Government in taking a much needed action. Along with this, the lack of health facilities across India can also lead to a large number of avoidable deaths, as even today there is a crisis of proper protective gear for health officials who are at the ground level.

The ratio of the population to the number of beds is also less, at 0.55 beds per 1000 of the population, and 5.18 beds per 1000 of the elderly population, in government hospitals. This national figure is also not consistent in all states, with some states like Bihar, Uttar Pradesh, Jharkhand lying even below these figures. Private hospitals although exists, they are largely inaccessible to a majority of the population.

So without a coherent and consistent action plan by the Government within the next few days over and above the lockdown, it can prove to be a disaster for the country and take it, as in PM Modi's words, "21 years back in time." 

As the world continues its battle against the first wave of COVID-19 virus, in China about 5 to 10 percent of recovered patients who previously tested negative on retest have been tested positive. Although virologists think it is highly unlikely that patients who have recovered recently will be affected by the virus again, there remains a level of uncertainty, and with that, a fear of a second wave. In such a situation, for countries like India, which are in their early stages of the outbreak, and for European countries, and America for whom it is judged to be too late, to protect themselves from a probable second wave or even any other pandemic that might occur in the future, there are important measures and lessons to learn. Implementation of these measures can be crucial in deciding whether a country is crushed or is able to survive this pandemic.

.3 months ago

Well written !!

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