There is no cure for Covid-19 today so the best we can do is figure out who has the virus (symptoms or no symptoms) and try to mitigate the spread.
Other countries had their principal outbreak before us and might offer us public health lessons to learn from. China was slow to admit to the outbreak at the beginning but then attacked with draconian swiftness, including the total lockdown of nearly one billion people. The speed with which they eventually moved is a lesson for us but their top-down heavy-handedness would most probably not work in a democracy like ours.
South Korea, Taiwan, Singapore and Hong Kong have to date brought the outbreak under control while still keeping their economies functioning. Korea used swift action at the beginning, widespread testing (10,000 a day early on) and contact tracing to rein in the outbreak.
All the Asian countries affected by Covid-19 have a long history of dealing with public health outbreaks, including SARS in 2003 and the Swine Flu in 2009. So when a virus surfaces they are accustomed to moving quickly. Singapore and Taiwan restricted and then cancelled flights from China and implemented widespread testing. Contact tracing using cell phone and camera surveillance was common but might not be accepted here with our tradition of personal liberty. When the coronavirus was discovered on the Diamond Princess after a stop in Taiwan, text messages were sent to every phone on the island listing every location passengers from the ship had visited. Officials followed up with cell phone users near those locations.
In Europe, Italy has been hit very hard but new cases seem to be plateauing and the government is working hard to test for those who have survived the infection and might have developed an immunity. One town, Vo near Venice, took the extraordinary step of testing and retesting every resident and basically eliminated all new infections. Speedy and comprehensive testing works.
As a counterpoint in Europe, while Denmark and Norway have locked down their economies, Sweden has kept restaurants and shops open. The government put its trust in the public’s self-restraint and sense of responsibility. At first it seemed to work, but now infections are spiking.
So what are lessons for us from other countries? First, you need to act fast and act early. Many countries were able to perform contact tracing on the initial cases, significantly reducing the spread of infections. We have waited too long for contact tracing to work. Second, you need to implement testing of everyone, not just those seriously ill, and results need to be reported back quickly – – not in one or two weeks. You need to be ahead of the curve anticipating where the next outbreak will be, not behind. Third, you need to have a comprehensive, transparent national strategy. This has been difficult for us because we don’t have a history of dealing with public health emergencies. In addition, power in the US is decentralized – – and without strong Federal direction, you are likely to have 50 states going in different directions.
The good news is a number of countries successfully mitigated the Covid-19 outbreak while keeping their economies functioning. The virus may resurface (China and Singapore are experiencing a bit of this now), but their experience offers proven strategies for us to draw on in this fight.
