Lessons from East Asia in fighting Covid-19
Johannesburg - East Asian countries have amazed the world by how effectively they have fought coronavirus infections – reducing the spread with the least disruption to their economies.
Bloomberg’s Covid Resilience Ranking, which measures how effectively the virus has been handled, lists 10 Asian countries in its top 15. While New Zealand, Australia and Singapore have done exceptionally well, Japan, China, and Vietnam have followed exemplary protocols, and their collectivist cultures have gone a long way towards ensuring a successful battle against the pandemic.
New Zealand, which is ranked number one on Bloomberg’s list for its success in curbing the pandemic, has experienced low community transmission, at times confined to bin lids and lift buttons. Many experts believe it is due to the government’s “hard and early” strategy and community culture of communication, empathy and cooperation. New Zealand’s small population, remote location, and political culture that promotes collective action seemed to make the difference.
Australia’s hard lockdown and concerted contact tracing kept the numbers low and the country enjoyed periods of zero new infections. Singapore has had the lowest Covid fatality count globally, recording only 29 deaths by December 21.
Travellers from Malaysia and Indonesia were forced to go into a 14-day quarantine at dedicated facilities, and those in breach of the quarantine were fined $10 000 or up to six months in jail. Singapore’s sophisticated contact tracing and enforced compliance ensured that the virus was kept under control. Singapore’s geographic insulation also contributed to its success.
Indonesia, the world’s largest archipelago, was far less successful than its other Asian neighbours. Its numbers of coronavirus infections were some of the highest in Asia, with confirmed cases having recently surpassed 1 million. Its recent average daily increase has been well above 11 000. Indonesia’s record is largely due to the failure to enforce health protocols, and the fact it has had the lowest testing and contract tracing rates globally.
When South Africans went into hard lockdown in March, Indonesians in the capital Jakarta were still frequenting packed night clubs and restaurants despite the spread of the virus. The Indonesian government did not want to impose tight restrictions, but only encouraged social distancing, which people were slow to comply with.
Japan is a particularly interesting case study as it has suffered just 18 Covid deaths per million people, by far the lowest in the G7, without mass testing or strict lockdowns. Experts say that the government very early on learned lessons from the case of the Diamond Princess cruise ship which had been a petri dish of Coronavirus infections just off Japan’s shores. Japanese scientists realised that the virus was primarily spreading through the air, and so in March the government went on a concerted campaign to ensure that its people avoided what it called San Mitsu, or the three C’s – closed spaces, crowded places, and close contact settings.
What made the campaign so successful was the Japanese people’s propensity to listen to that message and comply. The government identified five specific dangers to people, and the people listened. Those being dinner parties with alcohol, drinking and eating in groups of more than four, talking without masks at close quarters, living in dorms and small spaces, and using changing or break rooms.
Japanese people, who are already amazingly hygiene conscious, listened to those warnings. Some businessmen started carrying gadgets to measure the quality of air ventilation during their meetings, and even with good airflow, wore masks and shields. Wherever possible windows were always open and on subways people were encouraged to sit diagonally not across from each other.
Japan’s effective contact tracing, its good health care and well equipped hospitals, and the fact that only 4.2% of Japanese adults are obese (which makes the virus more lethal) all contributed to the country’s success in curbing the spread and fatality of the virus.
Vietnam also has a very interesting success story to tell in its fight against the virus. Vietnam has an impressive record in fighting outbreaks.
The WHO recognised Vietnam as the first country to contain the SARS outbreak in 2003, and it successfully combated the H1N1 bird flu. Despite its lack of resources compared to other developed countries, it has always made significant investments into its public health infrastructure.
Thanks to Vietnam’s meticulous contact tracing, strict quarantine measures and rigorous testing, it had no Covid-19 community transmissions between February and March last year, and between April and July. By late April Vietnam had the highest test ratio per confirmed case in the world. The government shut the country’s borders in late March and suspended all international flights.
Vietnam implemented what it called “third degree” contact tracing whereby if a person had been found to be less than two meters from an infected person for thirty minutes they would be tested and quarantined for 14 days at a government facility even if they had no symptoms, and all costs were covered. When the borders were later opened, all arrivals had to spend 14 days in quarantine at army run camps or hospitals free of charge, and have since September been allowed to pay for their own quarantine accommodation in specific hotels. Any violations of containment measures are strictly dealt with.
Vietnam’s proactive prevention measures have been exemplary, and the country even developed their own testing kits in January last year, enabling them to get Covid-19 test results within an hour with 90% accuracy.
The results of their tests were faster and easier to use than those used by the US Centers for Disease Control. Early in the pandemic Vietnam donated face masks to France, Germany, Italy, Spain, Germany, Russia and the UK, and provided free medical equipment to Cambodia and Laos. Vietnam has benefited from its close relations with Cuba and learnt from Cuba’s medical expertise.
The Vietnamese people have a collectivist culture, and complied with their governments dictates, and by mid August last year, 17 million residents had downloaded Bluezone, the government’s contact tracing app. Private citizens even set up rice ATM’s to dispense free rice, and ATM’s which dispense 20000 free face masks a day.
China has also had extraordinary success in curbing the coronavirus through hard lockdowns and meticulous contact tracing.
Early in the pandemic China implemented a policy of Ling Jiechu, or zero contact, and drones delivered messages on the streets about staying home and wearing masks. Citizens had to have formal passes to leave their apartments, and could only go out to buy food and medicine every few days. Neighbourhood committees assisted with the delivery of food and assisted the elderly, and caretakers in apartment buildings had to take peoples’ temperatures. All these measures worked rapidly towards curbing community transmission.
China’s culture of moral compliance with rules ensured that people obeyed restrictions, and the government’s use of technology in supporting its fight against the virus was groundbreaking. The use of artificial intelligence, block chain, cloud computing and big data all worked to ensure minimal community transmission in a population of 1.4 billion people.
Traditional Chinese medicine (TCM) combined with Western medicine have proved effective in treating symptoms, and by December 31st the government gave conditional market approval for the first vaccine developed by state owned Sinopharm, with 79 per cent efficacy. TCM has also played a role in reducing the severity of the virus.
Lian Hua Qing Wen is one promising treatment for Covid-19, particularly in mild and intermediate cases. Jinhua Qinggan Granules (a combination of 12 herbs) have also been effective in reducing fever time and detoxifying the lungs.
There is little doubt that East Asia’s communitarian culture and collectivist spirit, combined with peoples’ respect for government restrictions in a public health emergency “for the good of all” have contributed to the successful record of many countries in curbing the virus.
* Shannon Ebrahim is Independent Media’s Foreign Editor.