A view of nearly COVID-19 free world

©Health Analytics Asia

As the world transitions into the next stage of the global pandemic, we look at how Asian countries have handled the initial Covid-19 outbreak response to fight the pandemic.

By A.Ahmed

While COVID-19 proved a catastrophic failure of public health leadership in some of the wealthiest nations in the world, a few Asia-Pacific or APAC countries are leading the world by the way they handled the initial outbreak response to fight the pandemic.

Thailand, for instance, has ranked number one in the world out of 184 countries for its ongoing COVID-19 recovery effort, according to the Global COVID-19 Index (GCI). Published on 28 July, Thailand received an index score of 82.06, putting it on top of the global chart as an example of best practices in tackling the ongoing global pandemic.

In fact, the smaller nations such as Taiwan, South Korea, Australia, and New Zealand are among the top countries that have tackled the crises efficiently causing less mortality even among its aged and co-morbid population.

In the recent GCI survey, South Korea ranked second with a recovery index of 81.09, followed by Latvia (80.81), Malaysia (79.37), Taiwan (78.94), and New Zealand (78.55).

Australia, which used to be number one in previous months, fell to sixth, with a recovery index of 77.18.

While some of the big powers in the world were running short on masks, gloves, ventilators, critical personal protection equipment to fight the global pandemic, no such crises were seen in any of these Asia-Pacific countries.

These countries, according to experts, banked upon a combination of social distancing, testing and contact-tracing, and clear communication, which helped them to fight COVID-19 successfully.

Experts believe these countries also relied on their historical investment in building public healthcare and quick preparedness in dealing with the pandemic. One of the primary measures that contributed to their success was the early response from their healthcare system.

Also, if we go by the healthcare spending of these nations, according to the World Bank data, Australia spends 9.21% of its Gross Domestic Product (GDP) on health, New Zealand spends 9.17%, South Korea spends 7.60% and Taiwan around 6% of its GDP on health.

Taiwan (443 cases; 7 deaths)

Taiwan halted the virus right at its doorstep. The country of more than 23 million people reported its first COVID-19 positive case on January 20, 2020.Situated merely 130 km off the coast of mainland China, Taiwan even lifted its

stringent restrictions on June 7, after witnessing no transmissi

on of the disease in straight two mo

nths. Believe it or not, but the credit goes to the country’s president, Tsai

Ing-Wen, an economist and its vice-president, an epidemiologist trained at the US-based Johns Hopkins University. In fact, when at the beginning of the year, the officials at the Taiwanese Center for Disease Control (CDC) saw some internet discussion on the outbreak of typical pneumonia or SARS-like disease in Wuhan, they got very nervous.The country even fired off an email to the WHO for clarification, alerting other countries about people f

alling sick with mysterious pneumonia in the Chinese city of Wuhan.

Meanwhile, as part of setting up their own mechanism for dealing with the possible COVID-19 cases, Taiwan started screening the passengers coming back from Wuhan.

Gradually, the Central Epidemic Command Center started going on television every day with live interviews where the press asked all kinds of questions related to the outbreak and the government maintained transparency.

Transparency, to an extent, has been the key to Taiwan’s success.
Even US President Donald Trump on April 17 cited Taiwan as an example to criticise the WHO. “Why did the WHO ignore an email from Taiwanese health officials in late December alerting them to the possibility that coronavirus could be transmitted between humans,” he asked.

Activated on January 20, the Central Epidemic Command Centre proceeded to implement a couple of measures to contain the spread of the virus, including but not limited to border controls, fever screenings, and banning exports of surgical masks.

Within 10 days after the flareup of the mysterious new virus in Wuhan, Taiwan closed its borders and extended the restrictions to all arrivals from China, six days before any other country did so.

Besides, Taiwan also issued a ban on all port calls by international cruise ships on February 6, to prevent more cases like the Diamond Princess.

As the virus began to spread outside China to places like Thailand and Singapore, travel advisories were issued to these places as well. By early March, all foreign arrivals without a residence permit were banned from entering the country.

Soon after its own success, the Taipei Government launched the “Taiwan can help” campaign. As part of this initiative, the country donated 7.07 million medical masks to support frontline medical personnel in some of the severely affected countries, including the US, European nations, diplomatic allies, New Southbound Policy partner countries, Japan, and a number of African and Middle Eastern nations.

Taiwan’s response ranks among the world’s best.

South Korea (11,902 cases; 276 deaths)

In contrast to Taiwan, which had closed its borders and restricted international flights, South Korea conquered the deadly virus with aggressive early response and without a lockdown.

The country launched a massive, technology-reliant testing and tracing campaign; a by-product of lessons learned from its bitter experience with the Middle East Respiratory Syndrome (MERS) epidemic in 2015.

Its continued vigilance, extensive testing and contact tracing, isolation, and treatment of confirmed cases remains a model that most other countries only aspired to follow.

While citing various measures that helped the nation to control the outbreak, officials in the South Korean government say that it was the response of the central and local governments, close cooperation of its people, and the country’s free press that helped to control the COVID outbreak by mid-March.

South Korea shared relevant information transparently and promptly and provided situation updates and related response measures to the public through two regular briefings on a daily basis.

“Korea has managed to achieve a remarkable turnaround in infection prevention, control without a lockdown. The credit goes to the public’s voluntary adherence to personal hygiene and social distancing, thereby avoiding the need for any coercive measures that may inflict greater damage on everyday life and restrict freedom,” said an official document.

The country introduced various innovative infection prevention and control programs such as the Special Entry Procedures designed to block the entry and spread of the virus without the need for a lockdown or restrictions on movement, the Living and Treatment Centers dedicated to the treatment of mild cases, and the drive-through screening stations for safe and efficient swab collection — all of which proved to be effective in infection prevention and control.

Korea with a capacity of conducting over 23,000 diagnostic tests per day successfully managed to keep the outbreak from expanding further.

Australia (7,276 cases; 102 deaths)

Despite being a large and populated country, Australia has not only managed to keep the number of infections low, but the country has also been highly successful in ‘flattening the curve‘.

Australia reported its first COVID-19 case on January 22 and since then the country has witnessed 16,303 cases, of which 9758 have recovered and 189 have died. The country has performed
4,164,454 tests so far.

Australian National Cabinet came up with a three-step plan to gradually remove baseline restrictions after imposing it. As part of the plan, each state and territory government had the power to decide which restrictions could be eased or resumed based on their local circumstances.

However, the country showed a strong commitment to
(1) Stay 1.5 meters away from other people whenever and wherever they can.
(2) Maintain good handwashing and cough/sneeze hygiene.
(3) stay home when unwell, and get tested if any respiratory symptoms or fever is experienced.

New Zealand (1,504 cases; 22 deaths)

Like other countries of the Asia-Pacific region, New Zealand, an island country with a population of 5 million, under the charismatic leadership of its Prime Minister Jacinda Ardern kept the world informed about its fight against the COVID-19 on a daily basis.

While other countries were still struggling to fight COVID-19, New Zealand preferred to completely eliminate it. The country could even afford to do it, owing to its small size and isolated location.

Since February, the New Zealand Government has restored its strict lockdown. It issued an epidemic management notice and further strengthened travel restrictions, closing borders to almost all travellers from mid-March onwards.

According to the BBC, Prime Minister Jacinda Ardern even said these were the strictest regulations in the world, for which she would “make no apologies.” Later the country closed the borders entirely to almost all non-citizens or residents.

On March 23, the Prime Minister of New Zealand issued an Epidemic Notice under section 5 of the Epidemic Preparedness Act of 2006. An Epidemic Notice is a public policy tool to help government agencies respond swiftly and effectively in a rapidly evolving situation.

According to the Coronavirus Resource Center at Johns Hopkins University, New Zealand has reported 1,504 cases and 22 deaths. Even at its peak, New Zealand had only 89 cases a day.

With no active COVID-19 cases, the island country has now ended most of its coronavirus lockdown restrictions. Malls, retail stores, and restaurants have reopened, and many people have started to return to their workplaces. The gatherings, however, will be limited to ten people and social distancing guidelines will still remain in place.

In sum, New Zealand’s strategy offers useful guidance to policymakers on how to respond to future pandemics in all countries.