Whether out of fear of repeating the past, the virus, economic trouble, or public criticism, nations have responded differently to the pandemic. Although it’s not over, and it’s still too early to determine the long-term effects of each strategy, the data thus far does suggest which measures have worked best and why.
Two methods for containing the spread of coronavirus are herd immunity and lockdowns. The Mayo Clinic states that herd immunity occurs when a large portion of the community becomes immune to a disease making the spread of it unlikely. Ideally, herd immunity is achieved through vaccinations. Vaccines have a low risk of complications and illness, they protect vulnerable populations that cannot receive vaccinations, and they have a strong history of controlling the spread of highly infectious diseases.
At the beginning of the pandemic, vaccines were a hopeful but distant solution. Now, the first shipment of Pfizer’s vaccine will arrive in the U.S. on December 15. The U.K. became the first to approve it for use with their announcement on December 2. The shortened approval process, 10 months as compared to 10 years, as well as the U.K.’s reliance on Pfizer’s data instead of independent analysis, has made some hesitant to follow Britain’s lead. Dr. Anthony Fauci, the U.S.’s top infectious disease expert, took the opportunity to praise the Food and Drug Administration’s slower regulation process and offer support for the agency which has been under pressure by the White House to approve the vaccine.
Achieving herd immunity can be difficult when people refuse to take the vaccine. Additionally, the effectiveness of vaccines can wane over time. If multiple vaccines are necessary to inoculate against a certain disease, it’s not guaranteed people will complete the series lessening the effectiveness.
The World Health Organization (WHO) has criticized the other, widely used approach, lockdowns. Lockdowns, or large scale physical distancing measures, slow the spread by limiting contact. They harm social and economic life and disproportionately affect people living in poverty, internally displaced people, and refugees.
In Europe, both Italy and Greece have utilized lockdowns with different results. Originally, Italy was the hotspot of Europe, while Greece initially had a low number of cases. Italy declared a state of emergency and placed a strict lockdown. Greece acted similarly but did not declare a state of emergency. With such similar methods, the two nations should have yielded similar results. However, one key factor that separates them is timing. Italy began suspending events and closing schools nine days after the third confirmed death from coronavirus. It closed non-essential shops and banned non-essential movement after two weeks. In comparison, Greece suspended events and closed schools before the third confirmed death, closed non-essential shops one day after, and banned all non-essential movement only eight days after the third death.
Timing also played a key role as to why Taiwan and South Korea have both had continued success with their efforts. Taiwan went into a strict lockdown very early, like Greece. However, it did not last long. Instead, they moved to closing borders, banning the export of surgical masks, contact tracing, and mobile SIM tracking. They kept businesses open by requiring temperature checks and offering sanitizer before each person entered. These efforts have resulted in just seven deaths. South Korea responded similarly and has not only low death rates but also a low case count. Their early and aggressive response included and still includes extensive testing, isolation, contact tracing, and tracking COVID patients in real-time. They have also managed to keep businesses open, and a sizable government stimulus helped citizens financially.
Both nations had experience with epidemics in recent history, Taiwan with SARS 20 years ago and South Korea with MERS in 2015. This may have made them better prepared and primed citizens to comply with strict and invasive measures early on. While some question the privacy violations associated with SIM contact tracing and patient tracking, the low case and death count, as well as the public’s willingness to follow such measures, highlight that people are willing to make the tradeoff between personal freedoms and restrictions to avoid disastrous outcomes.
Rather than focusing on limiting the spread of COVID and protecting citizens, Turkey has focused on restricting the spread of information. Starting in March, officials have investigated doctors and healthcare workers commenting on the government’s actions and coronavirus in the media. In one instance, after a health expert talked about underreporting of cases with local media, a governor claimed they were “misinforming the public” and “causing panic.” The investigation brought against them was dropped only after multiple rights groups condemned it.
But public support for Turkish doctors and nurses is waning. Increases in resignations led some to liken them to soldiers fleeing a battlefield. However, many that left public hospitals did not leave medicine altogether but moved to private care facilities that have better working conditions. Doctors were even prohibited from retiring between March 28 and June 8 and starting again on October 27.
Turkey has continued to declare the situation is under control and lift partial lockdowns even when independent doctors and medical associations warn against it. In addition to keeping information from its people, Turkey has also not followed WHO’s recommendation of regularly releasing case and death numbers by city or include probable causes in their counts.
While many countries took action at the beginning of outbreaks, the strength and continued enforcement of their policies have differentiated the success of their efforts. Time will tell if Italy and Greece’s regional measures and extended lockdowns save them from further spikes. Countries like Taiwan and South Korea have managed to not only protect most of their people but also protect their economies. This has improved their governments’ images both among their people and around the world. Turkey inverted its approach, starting with appearances and putting science second, leading to discontent among its people and healthcare force, arguably making their efforts a failure.