Who’s Succeeding Against the Coronavirus and Why

Four months after the coronavirus outbreak was declared aglobal health emergency, countries around the world have seen vastly different results from their efforts to fight the pandemic. Some have beaten an initial onslaught, some are in the middle of it, and some have yet to see, or at least report, that the virus is causing havoc. Factors both in and out of the control of individual countries have influenced their different outcomes so far. Here’s a breakdown of some things we’ve learned:

Acting Early Helps

Early testing is paramount. Countries that rolled out good diagnostics in January — including South Korea and Germany — have managed their crises comparably well, since it enabled policy makers to react quickly to the growing threat and convinced people of the danger at hand. The picture was grimmer for countries that failed to put early testing into effect, including the U.S. There, the virus spread largely unchecked through February. When cases exploded, hospitals in hot-spots such as New York City were overwhelmed, states had to compete with each other for essential equipment, and citizens were subjected to conflicting, often highly politicized messaging about the stakes of the twin health-care and economic crises.

Geography Counts

While the virus obeys no borders, it spreads only where humans are allowed to go. That’s enabled island nations such as Japan, Iceland, New Zealand and Australia to reduce new daily confirmed cases to extremely low numbers by fully isolating themselves. The number of visitors to Japan, for example, fell 99.9% in April compared to a year ago. It remains to be seen whether infections will remain so low when these countries start allowing more arrivals. Geography can also pose challenges. China, where the pandemic began, acted swiftly and curbed its outbreak. But in re-opening its economy, it’s had to take special precautions to prevent case spillovers along its borders withRussia, which has one of the biggest outbreaks in Europe, andNorth Korea, which has yet to report any infections.

Preparedness Helps

Once the virus begins circulating, a new set of questions arises: Are those who develop bad cases of Covid-19 getting to hospitals fast enough? Do medical workers have sufficient personal protective equipment to safely care for the sick? Are there enough ventilators and intensive-care beds to accommodate the worst cases? Public-health officials and policy makers all over the world have long discussed the probability of a pandemic like this one. Now that it’s here, the impact of the decisions that were made — or postponed — are glaringly obvious. In Brazil, where caseshave soared, the public health system was already under strain before the pandemic, and the country has beenunable to form a coherent strategy to stop the spread. In Taiwan, by contrast, acombination of early health screening for arrivals to the country, thorough testing and contact tracing, and widespread medical mask usage has brought new domestic infections close to zero.

Strong-Arm Tactics Work

China raised eyebrows globally when it locked down tens of millions of people in January to stanch the spread of the virus. The effort worked, and was soon copied by countries on other continents. As China re-opens, it’s raising eyebrows again — withmeasures most countries probably will deem too intrusive. For example, authorities use data from government departments, phone carriers, locations and transactions to assign citizens a color-coded risk level. Millions of people have to show they have a green code on their mobile phone before being allowed into hotels, restaurants, shops and subways or out of their residential compounds. The codes are updated frequently. Just visiting a shopping mall where an infected person also went can change one’s code to yellow, which forces mandatory home isolation, as does a red code, for those who are infected.

A Softer Touch Can Work, Too

Less restrictive measures have also succeeded. In Japan, whose outbreak didn’t really arrive until April, the governmentdeclared a state of emergency and instituted stay-at-home requests. By mid-May, rates of new infections had fallen and the government lifted its state of emergency for 39 of Japan’s 47 prefectures, although Tokyo and other dense economic centers remained under heavy restrictions. Similarly, Germany has maintained a relatively permissive quarantine regime. And it’s begun opening up again in recent weeks, in part thanks to a robustcontact tracing program that it has maintained throughout its outbreak. Thanks to some of the world’s toughest privacy laws, the country’s 375 local health authorities couldn’t rely on digital surveillance for help. Instead, they recruited teams ranging from medical students to firefighters, who work via email, telephone, and sometimes even fax. Their work is considered a key reason Germany has about a third the number of coronavirus deaths per capita as the U.S.

Trust in Government Helps

The credibility of policy makers matters at a time when citizens are flooded with news, scientific research (some of it bad) and often conflicting messages about how to support both public health and the economy. Countries with lower levels of trust in authorities are especially vulnerable to conspiracy theories that some are calling the “Infodemic.” Distrust of the government in Iran, after it lied to cover up the military’s mistaken downing of a civilian airliner Jan. 8., led citizens toignore directives not to travel during the Persian New Year, in late March. In a Pew Researchpoll from April 2019, fewer than 1 in 5 Americans said they trusted the federal government to do the right thing; in the 1960s, it was around 4 in 5. Meanwhile, trust in thegovernment is high in Germany and South Korea. The same is true in Singapore, which had early success containing the virus that was set back byan outbreak among foreign workers.

The Reference Shelf

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