Report Card: World’s Best and Worst Government Pandemic Responses

Food delivery riders wearing facemasks amid concerns over the spread of the COVID-19 novel coronavirus, wait for delivery assignments outside a restaurant in Beijing on March 20, 2020. (Photo by GREG BAKER / AFP) (Photo by GREG BAKER/AFP via Getty Images)
GREG BAKER/AFP via Getty Images

A few countries were still reporting zero infections from the Wuhan coronavirus this week – and some of those reports are viewed with extreme skepticism by outsiders – but at this point, the disease has reached most of the world’s large nations.

Some exceptionally good and bad responses have been noted, judged by both their effectiveness at halting the spread of the virus and the hardships inflicted upon citizens.

Worst – China: The list must obviously begin with the source of the virus, the Hubei province of China and its capital city of Wuhan. The Chinese Communist Party (CCP) suppressed information about the emerging threat, fed false data to international observers, sought to undermine travel bans that were the only effective means of keeping the virus from becoming a global pandemic, used its economic leverage to hinder the response of other nations to the pandemic, and implemented incredibly callous control measures once the virus could no longer be concealed or downplayed.

The Chinese Communist Party’s actions unquestionably unleashed the coronavirus on the world. A recent study estimated 95 percent of all coronavirus infections worldwide could have been prevented if the CCP listened to whistleblowing doctors in December instead of silencing them. To this day, China’s claims about the pandemic cannot be trusted, so it is difficult to tell how effective its measures against the virus were or how many people suffered under the harshest actions it took.

Although the Chinese government made some noise about cracking down on the unsanitary trade in wild animals and “wet market” bazaars that are often blamed for releasing the coronavirus into the human population, the sizable wildlife industry has been blamed for previous epidemics without leading to any significant reforms.

Worst – Iran: The deadliest outbreak after the coronavirus escaped from China occurred in Iran, where several dismal vectors combined to create a public health nightmare, including a lack of official transparency as great as China’s, social customs involving close physical contact, heavy traffic into crowded religious sites, religious authorities giving bad advice and incredibly dangerous orders to their followers, an election that should have been canceled, and the regime’s preference for spending money on weapons and sponsoring foreign terrorism instead of medicine and social services.

Iranian government data on the coronavirus outbreak is so obviously false that no one really pretends to believe it, including local Iranian officials. Official pronouncements vacillate wildly between treating the epidemic like a mild inconvenience or a dire threat. 

Worst – Italy: Assuming China’s numbers are accepted, Italy’s total deaths from the coronavirus surpassed China’s on Thursday – 3,405 and counting in Italy versus 3,245 in China. Italy’s 41,035 total cases spiked almost 15 percent on Thursday as well.

The results in Italy are undeniably terrible, so there will be much analysis of what it might have done differently. The government has been criticized for waiting a bit too long to impose control measures that were rolled out in a confusing manner to be received poorly by a society with a tendency to cut corners on rules that do not seem to make sense. Italian officials were not all on the same page until recently, so some regions of Italy responded more effectively than others.

Italy’s aging demographics, some unhealthy lifestyle choices, and extensive contact between older and younger generations in large families have been cited as reasons the disease spread so quickly and killed so many. 

Italy has about 300,000 Chinese residents, many of them living near Milan and working in the fashion industry, who complained of “bullying” and “discrimination” in January as the truth about the scale of the coronavirus epidemic emerged. Italian politicians from the area boasted of the high degree of travel and tourism between the Milan area and China. The Chinese Communist Party actually produced a propaganda video for distribution in Italy in early February telling Italians to hug their Chinese neighbors to prove they were not prejudiced. Chinese-Italians say they are still encountering racism as the coronavirus crisis spreads across Italy.

Italy’s healthcare system was clearly overwhelmed by the coronavirus, fostering much apprehension among other countries that wondered how their own systems might fare under such pressure. Some theories of Italy’s remarkably dangerous outbreak suggest the virus spread rapidly through hospitals once a surge of coronavirus cases poured in. Chronic shortages of medical personnel may have contributed to the spread, as harried doctors and nurses worked long hours without a chance to be tested and quarantined themselves if necessary.

Worst – North Korea: North Korea is simply a giant question mark, a void of reliable information. The paranoid dictatorship claims to have zero coronavirus infections, but most outside observers strongly doubt that claim. Concealing vital health information with an undeniable international impact is clearly among the worst possible ways to respond to a pandemic.

Best – Taiwan: Taiwan’s remarkably effective response to the coronavirus kept cases down to double digits until Wednesday, when it reached 100 infections. 

Taiwan’s response plan, which included 124 action items, is discussed in greater detail here, but in short, it relied on aggressive testing, information management (including some very intrusive electronic monitoring), cooperation between medical providers, unity among politicians, a high degree of cultural cohesion, a relatively small landmass, and firm control of its borders to isolate and quarantine infections very quickly. Stated concisely, the Taiwanese government and medical community devised a comprehensive response plan, and everyone followed it.

Taiwan kept infections remarkably low despite close proximity to China and a large number of Taiwanese living in China. Taiwan’s profound distrust of China helped it disregard Beijing’s propaganda and plan an effective response, and it was arguably helped by not belonging to the World Health Organization (WHO) because Taiwan was able to focus on its own needs and ignore Beijing’s influence on WHO.

Best – El Salvador: El Salvador logged its first known case of coronavirus infection on Wednesday – a person who traveled to Italy recently, according to President Nayib Bukele. Bukele and his officials appear to have done one big thing right: they imposed a comprehensive national quarantine and travel ban before the coronavirus began spreading.

Best – Singapore: Like Taiwan, Singapore was heavily at risk of the epidemic spreading from China, but it kept infections very low until this week, when a surge of 47 new cases brought the total to 313. 

The bulk of these new cases came from outside Singapore’s borders, prompting the government to impose further requirements on travelers, including a 14-day self-isolation period for Singaporeans returning from abroad. More aggressive social distancing policies will also be introduced.

“We cannot afford to take further risks if the number of imported cases continue to rise. That is why we’re imposing additional border controls and travel restrictions today,” National Development Minister Lawrence Wong, head of the multi-agency coronavirus task force, said.

Singapore, like Taiwan, moved very early to block travelers from the outbreak region in China’s Hubei province. Singapore was one of the first countries to block inbound flights from Wuhan, for example, and it was generally even faster to restrict travel from outbreak areas than Taiwan.

Also like Taiwan, Singapore used aggressive screening to identify infected people and got them into quarantine fast, while implementing hygiene protocols that appear to have been followed by most of the island’s high-compliance society. Singapore is so energetic about identifying coronavirus patients and making sure they go into isolation that it uses detectives to track them down.

Singapore notably did not put as much emphasis on wearing masks as many other countries battling the coronavirus, but it achieved a high level of public cooperation with a number of other antiseptic techniques, beginning with proper hand-washing.

Best – Hong Kong: Most of what has been said about Taiwan and Singapore could apply to Hong Kong as well, except Hong Kong managed to implement effective measures while in the throes of a popular uprising. As of Wednesday, Hong Kong had less than 170 confirmed infections and only four deaths, measured against a population of more than seven million.

Hong Kong notably had a leg up on using masks, since they were popular with protesters before the advent of the coronavirus and popular with disease-conscious residents of the crowded city before that. Long memories of the SARS epidemic in the early 2000s helped Hong Kongers quickly come to a war footing against the new viral threat.

Hong Kong, Taiwan, and Singapore are all thought to be facing a second wave of coronavirus cases, so their defensive plans will once again be put to the test.

Most Improved – South Korea: Many South Koreans complain the coronavirus was allowed to spread too quickly in their country by permissive travel policies. About 1.45 million South Koreans have signed a petition to impeach President Moon Jae-in for acting too slowly to restrict travel from China, despite pointed warnings from the Korean Medical Association, and for sending too many medical resources to help with the outbreak there. The petition charges that Moon’s response “shows that he is more likely the president of China and not the president of the Republic of Korea.” Moon’s infamous pledge to Chinese President Xi Jinping that “China’s difficulties are our difficulties” will likely haunt the rest of his career.

Once the coronavirus hit South Korea, Moon was accused of responding too slowly and gravely underestimating the severity of the threat. The behavior of a secretive religious cult contributed to a massive outbreak of the Wuhan virus. The epidemic seemed out of control at the end of February.

South Korea’s rapid implementation of an aggressive coronavirus testing regime, complete with the now-famous “drive-thru testing” facilities, helped turn things around and push the coronavirus curve down. South Korea has demonstrably done more to control the epidemic through pure information processing, without resorting to large-scale quarantines or lockdowns, than any other country. A high degree of coordination between government agencies, private industries, and the public is credited for the quick turnaround in the epidemic: the medical community amassed information quickly, distributed it to the public effectively, and used it to guide the vast industrial power of private industry to make the necessary medical resources available.

Conclusions: With due allowances for the differences between each of the best and worst countries, particularly their respective sizes and population densities, effective coronavirus measures seem to include border controls to keep infections outside the country, effective testing for the disease, aggressive strategies to isolate infected people, efficient and easily-understood response plans, and a high degree of public compliance with those strategies.

The worst coronavirus epidemic environments, on the other hand, tend to feature government opacity, a correspondingly high level of distrust for the government, poor public hygiene, overstressed and understaffed medical systems, and difficulty implementing social distancing procedures.

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