Reaction to the Virus: How Societies Affect Fight against a Pandemic

China and South Korea have succeeded in curbing the outbreak of the new coronavirus thanks to measures that Europe considers unacceptable. The United States might suffer even more because of its health care system.

COVID-19 is the first pandemic people have encountered in the information age. One can easily monitor the number of sick people online, which creates the illusion of a common problem. However, statistics for the new coronavirus vary significantly depending on health care systems in different countries, and even more so, on the ways their societies are organized. These factors are local, not global.

Testing the System

The scale of the negative impact of the current pandemic is different for different countries. One of the major factors here is life expectancy. Countries that have a relatively high number of older people have taken a major hit, since representatives of the 75+ age group are the most vulnerable. Italy, Japan and South Korea are among the countries with the highest numbers of COVID-19 infections. The average life expectancy for Italy is 83.5 years, for Japan and South Korea, 84.6 and 83 years, respectively. In China this number is significantly lower – 76.9 years, in Iran – 76.7 years and in Russia – 72.6 years, so the number of people who are at relatively greater risk is smaller. For poorer countries, where life expectancy often does not exceed 70 years, COVID-19 probably is not that dangerous.

Another important factor is the state of each country’s health care system. Among Western countries, the U.S. is a notable example, where health care is extremely expensive. Even a standard visit to a doctor, covered by insurance, in theory, might involve paying significant additional costs. That is why, in order to provide Americans with facilities for diagnosing as many people as possible, the federal government has to take unprecedented steps, which the U.S. is just starting to figure out.

People’s lifestyles, habits and social norms also affect the speed of the epidemic spreading, and influence different strategies for fighting the virus.

How China Dealt with the Virus

China was the first country to confront the outbreak. Official statements reported that the first COVID-19 case was identified on Dec. 10, 2019. However, some sources claim that the early cases can be tracked to the fall of 2019. At first, the Chinese government did not realize the extent of the threat, so it was unable to prevent the spread of the virus. After some time, however, China took unprecedented measures. People located at the center of the epidemic were not allowed to leave their homes, having no other choice but to get essentials delivered.

It is hard to imagine similar restrictions in democratic countries. In Italy, only sick people have to stay at home, others can venture out to get food in supermarkets, although they have to stay at least one meter (approximately 39 inches) away from other people. The World Health Organization has not provided official statistics, but its recent report talks about 320,000 tests performed in Guangdong alone. By the end of February, companies were able to produce as many as 1,650,000 tests per week. The results of the tests were ready within one day. Now, the outbreak in China has stopped, and recently there have been just a few isolated cases.

So far, South Korea has been an absolute leader in the number of tests performed. By March 10, South Korea had tested 210,144 people, which amounts to more than 4,000 tests per 1 million people. The South Korean government did not lock down the whole country, but in many cases, it had to significantly overstep people’s privacy, and, at the same time, trust its citizens to act responsibly. After identifying a sick person, the authorities gathered information about his or her recent movements using a digital footprint – data obtained from communications service providers, banks and security cameras. After that, they released this data to the public. This way, they managed to identify almost everyone who had been in contact with people who were sick. Implementing similar measures is impossible in EU countries because their laws protect private information. The massive scope of the contact tracing campaign helped curb the spread of the infection, and could explain the low death rate in South Korea.

This may be the most realistic response to the epidemic, since other countries do not have reliable data about the number of people who are infected. Furthermore, most of the early patients were women under the age of 40, and they proved to have relatively strong resistance to COVID-19. Now, South Korea continues to test about 10,000 people per day and is planning to increase this number to 15,000-20,000 daily tests.

Little Champions

Some smaller countries managed to assess the risk very quickly and take severe steps even before the virus started to spread. At one point, 12,000 people were under mandatory home quarantine. The Singapore government also covered all the medical expenses of patients with coronavirus. These measures helped prevent exponential growth in COVID-19 rates in both countries. Bahrain reacted quite quickly and has performed 4,910 tests per 1 million people, which is the highest number in the world. Taiwan also succeeded in containing the epidemic by using similar methods: free mandatory testing, lockdowns and an extensive information campaign. Many experts argue that countries in Asia and the Middle East have learned a great deal from their previous experience in dealing with an epidemic, for example, SARS and MERS. In 2003, 300 people died of SARS (atypical pneumonia) in Hong Kong.

Now, European countries have to show their resilience since they are at the epicenter of the pandemic, according to the World Health Organization. The United States faces the same challenge. On March 13, President Donald Trump declared the COVID-19 pandemic a national emergency.

Italy in Quarantine

The first case in Italy, the country which is now in deep crisis because of the COVID-19 outbreak, was officially confirmed on Jan. 30, when two Chinese tourists from Wuhan in Rome tested positive for COVID-19. At the beginning of February, Italy introduced temperature checks at its airports, which helped identify and isolate a few sick people. At that time, the situation seemed to be under control. Everything changed on Feb. 20, when a 38-year-old man from Lombardy who had not traveled to China tested positive for the virus. Since then, Italy has implemented new measures to contain the virus almost every day, but authorities took the first truly preventive step only on March 9, when they decided to put the whole country on lockdown. By the middle of March, Italy was performing 12,000 tests per day. So far, the number of sick people and the official death toll have been growing exponentially. This is understandable since the incubation period for COVID-19 can last for up to two weeks. There was good news from the town of Codogno, which registered the first Italian resident with the virus. The government declared Codogno “a red zone” before it quarantined the country, and on March 10, the town did not register any new cases.

A relatively high death rate in Italy compared to China and South Korea cannot be fully explained by the age of its population. Some experts point to the way Italy calculates the COVID-19 death rate. Italy includes in its statistics the deaths of all people who tested positive for coronavirus, unlike Germany, for example, which considers patients’ underlying medical conditions.

Other European Countries Are Catching Up

As of March 13, coronavirus was spreading rapidly across Spain, France, Germany, Switzerland and Norway. It is obvious that to prevent the spread of the virus, all countries within the EU will have to seal their borders. The EU countries are also trying to adjust their health care and social insurance policies (although these measures will likely produce different effects since even the total number of hospital beds in each country varies). Also, all of them might have to quarantine their populations. Another complication is the difference in test availability in each EU country. For example, France is not performing enough COVID-19 tests, even though it registered the first death from the virus on the EU territory on Feb. 15, 2020.

A Test for Trump

The situation remains uncertain for the United States as well. The first coronavirus case was registered on Feb. 5, when a man tested positive for the virus after returning from his trip to Wuhan. After that, things were quiet for some time. On March 1, the United States announced the first coronavirus-related death. The research of the virus genome showed no evidence that the patient had contracted the virus outside of the country. Also, the patient had not been in contact with other sick people and had not traveled to China. This means that there are far more sick people in the United States than one might expect, and that these people have not been tested at a hospital. The good news is that the United States has a relatively younger population with a median age of approximately 38.3. (In Italy the median age is 47.3.) It means that there are fewer older people in the United States who are the most vulnerable to infection. However, this factor provides only modest relief.

Recently, The Washington Post has argued that the delays in production and performance of coronavirus tests are a major problem in the United States. By March 10, the United States had performed only 8,554 tests, which was one of the lowest numbers worldwide. American free market traditions are blocking radical steps in fighting the epidemic. In addition, Republicans have blocked a bill against mandating paid sick leave for people showing COVID-19 symptoms. Accordingly, many Americans cannot take time off work and have to go to their office even if they get sick. Now the question is whether the situation with testing will improve now that Trump has declared a state of emergency to combat coronavirus.