Coronavirus has understandably affected countries in different ways, at a different rate. Different cultures, different population densities and different timelines mean that the spread of the virus varies from country to country and from city to city. Travel between countries is second nature in the 21st century so by the time the virus outbreak had been realised in Wuhan, China, there was no guessing as to how many other countries it had already unknowingly spread to. Each country’s government has devised different strategies to deal with their individual situations, some with more efficacy than others and some needing more drastic measures to be put in place soon after.
Wuhan in China was the epicentre for the virus outbreak and China has one of the highest rates of cases and deaths. In possibly the strictest strategy seen in any country, the lockdown began in Wuhan on the 23rd of January 2020 where residents are forbidden from leaving their homes without permission, and citizens are rewarded for reporting those not following quarantine instructions. These measures seem harsh and may be hard to enforce in democratic societies, but it has been credited for preventing any further spread and if this strategy was possible in other countries around the world it would do great things to prevent the rapid rate at which the virus is currently spreading.
Thus far, Italy has a similar number of cases to China and the USA, however the death rate is much higher. To combat this, on the 10th of March the Italian government announced that people should stay home apart from essential work and emergencies, with public gatherings and domestic sporting events suspended until April 3rd. They have taken to closing universities, schools, and restaurants by 6pm each day and moving from one town to another requires a signed form giving reason for traveling. Finally, the Italians seem to be respecting the restrictions, behaving responsibly, which has led to a less steep increase in cases.
Germany, Spain, Iran and France
With Germany having one of the higher number of cases seen in the world, Berlin responded by calling off all performances at theatres and opera houses and a number of football matches of the league Bundesliga will have no crowds. In the last week of March it banned gatherings of more than 2 people and a distance of 1.5m is to be upheld. Spain also went under lockdown mid-March, restricting gatherings in the areas and travel without a valid reason. Like Germany they are not allowing crowds at football matches and they are banning travel between Spain and Italy. Some may say that these measures have come too late as the cases and deaths are climbing faster in these countries than many others around the world.
In Iran, public gatherings have also been cancelled, schools closed and crews of cleaners dispatched to clean public transport and places of gathering. However some Iranians are criticizing the government, claiming that they delayed revealing scope of the outbreak until elections were over. Also cancelling gatherings of more than 1000 people is France, who are also cancelling markets, community groups and church services in the areas of Morbihan, Haute-Savoie and the départements of Oise and Haut-Rhin in north east France according to The Local France. President Macron is advising against visiting older people, but is not closing schools as of yet. Following criticism France is looking into putting into place more widespread testing in a bid to end confinement. It is a definite positive that these countries are putting in place some restrictions, and infection rate could possibly be lower because of it, however are these tight enough restrictions to prevent catastrophic spread?
Following models by Imperial College London that showed where the UK is on Italy’s Coronavirus timeline, Prime Minister Boris Johnson in the UK recently announced a lock down for 3 weeks, more testing, and immediate closure of shops selling non-essential items. This comes after a previous strategy to attempt herd immunity was cast aside. The government is now waiting for its 329-page emergency bill to become law, which will allow draconian measures, more extreme than ever seen in the UK before. Many retired doctors, nurses, midwives, paramedics and social workers have answered the call to return to work to help with the emergency, aiming to ease the pressure on the healthcare sector.
Japan and India
Japan currently has tough border restrictions, essentially banning entry for anyone coming from South Korea or China until the end of March and anyone having already arrived from these countries is to go into a 14-day quarantine. They have cancelled the 2020 Tokyo Olympics for one year, and cases are currently low, with health officials expecting a further surge in cases. There are questions over whether their low statistics compared to the rest of the world are due to a lack of reporting or perhaps a lack of tests being carried out. If the cases and deaths are truly low in Japan, should they wait for it to get bad before enforcing self-isolation rules, or should they heed advice from the rest of the world and put these in place before it gets bad?
India is the most recent country to enforce a 21-day countrywide lockdown after a spike in cases over recent days. Narendra Modi pleaded for no panic buying and for citizens to stay indoors, ensuring that all essentials will be available. However the citizens have not heeded his advice, and have been crowding the streets in Delhi and Mumbai, wiping out all basics in shops. All domestic flights have been stopped.
South Korea and Singapore
In South Korea, people in cities across the country have been encouraged to stay home, offices and schools have been closed. In Daegu, the country’s most infected city, restaurants and shops are closed however the hospital system is clogged with patients with mild symptoms. Despite the failure in this city, South Korea has 50 drive-through screening clinics where health workers are processing up to 15,000 tests every day, each taking just 10 minutes. If every country was able to put in place these testing facilities then the outlook would be much brighter. They have also been proactive in subsidizing small and medium sized business owners to allow those employees with children off school to work flexible hours. South Korea has been praised for its response to COVID-19, and the reason it has done so well is most likely due to what was learnt from MERS that brought the country to a standstill in 2013.
One country that seems to have stayed out of the news for all the right reasons is Singapore. Geographically isolated and with the memory of battling the SARS outbreak in 2003, citizens have taken advice seriously and seemingly shut down the virus which first claimed a victim on the 23rd of January. After SARS killed 33 people in Singapore, they stepped up their healthcare system even more by improving training in infectious diseases, investing in equipment and setting up “fever centres’ so they could isolate suspected cases. It could be said that these were the measures that allowed Singapore to be ready in case of another outbreak. Another efficient practice that Singapore has been carrying out is contract tracing of an infected individual, working out exactly who that person has come into contact with and when. They can then advise those individuals to self isolate to prevent any further spread. It has worked to reduce the virus spread in Singapore, and the Prime Minister has been praised for having a calm, clear approach early on, but it is unclear whether these strategies would work in bigger countries who perhaps have less belief in their governments.
In the United States, the federal government has not put in place any significant measures to prevent the spread of the virus apart from restricting travellers from certain countries into the US despite having the highest number of cases currently. They are receiving criticism from around the world for this as being such a large country, if they don’t take drastic actions there could be huge national and global repercussions of not acting faster. Individual states with high numbers of cases have however devised their own strategies. So far 13 states have declared the strictest combinations of restrictions, some with looser strategies, and some with none as of yet. President Trump has asked Congress to pass a payroll tax cut and relief for hourly wage earners, in order to assist workers who may be squeezed financially by the coronavirus outbreak. With WHO warning that the US could become the new epicentre of the pandemic after Europe, should they be making tighter restrictions? Probably. Are they? No.
All countries are putting different strategies in place to prevent COVID-19 from infecting any more people than it already has, and there are takeaways to be had from each and every one of them. The world is facing a catch 22, where extreme social distancing will allow scientists long enough to develop a vaccine and reduce the spread of the virus, but this will have a detrimental economic impact. What is preferable to each individual government? Deaths, or an economic crash? It could be said that this is what is behind their strategies.
An ideal strategy would involve clear communication, honesty, mass testing, diligent contract tracing and preventing travel. Citizens would need to have high levels of trust in their government and heed advice. Relying on parents to take their children out of schools is unfair as they still need to pay rent, so governments will have to enforce these actions, and subsidise wages so that schools and offices are able to close.
It would be silly not to look back at previous pandemics and how they played out through history to see what we can learn this time around. Scientists are worried that countries will get to the point over the summer where infections are plateauing out, and testing will be commonplace. But as soon as we take the brakes off, the virus will come back with a vengeance just like the 1918 flu, and this is what governments need to build a preventative strategy for. Closing borders and social distancing are just giving us enough time to increase numbers of ventilators, PPE and get fast testing available so that when the virus hits back, we are prepared. The entire world needs to be in sync to have any chance to squash the virus.