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Home COVID-19 The CoviD-19 saga: What makes a Good Pandemic Response

The CoviD-19 saga: What makes a Good Pandemic Response

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Scientists and researchers continue to look at data on how the world’s countries are doing with their pandemic responses. This is because it is very important to know what works and what does not so it can be emulated in the long run.

But it’s never that easy. Although there are effects that can be clearly seen, factors such as total number of population, behavioral changes, geography, the economy etc. make it hard paint a definite picture, and make assumptions.

These factors come with other factors branching from it, and these branches form other smaller branches.

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For example a population may be divided by number of people above or below poverty line. Then, those below poverty line will be further divided into people who have access to food and water, and those without. Overall, even the smallest factors contribute to the bigger picture which is why there is such a thing as identifying limitations when reporting results and conclusions.

A Singaporean AI predicted that the Philippines’ fight against the CoviD-19 would end on 8 July but notes that this might not be accurate since the data for the Philippines are “all over the place”.

But, while data are limited because factors such as virus mutation or population movement were not considered, it can be said that it correctly estimated Vietnam’s duration, ending by 14 May, 2020.

Science and Health reveals data predicting that countries MAY suffer a second wave should they prematurely reopen. It didn’t say with certainty that they WILL, but there is data supporting that prediction. Thus, when Japan and Singapore softly opened, they were bombarded by a second wave of coronavirus cases.

Science and Health also has data showing that countries with belated preventive measures suffered direr consequences than those who that did preemptive lockdowns.

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This is the case in the Philippines where lockdowns happened only after there were reported cases, and Vietnam which shut down their borders even before its first case. Philippines is now suffering more weeks of economic recession while Vietnam is starting to slowly open.

Although we might need a lot of data-gathering to be accurate with how we judge a country’s pandemic response, there are already obvious signs that a country is winning or losing the pandemic war creating a pattern that can be discerned even from a layman’s standpoint.

Governments that were extremely proactive and quickly put in place robust testing regimens, contact tracing, and imposed strict quarantines at the short-term expense of their economies, fared better than governments who were in complete denial and downplayed the crisis for fear of negative economic repercussions.

Successful responses didn’t even depend on regime type.

Democratic countries such as Taiwan, South Korea and New Zealand have had fantastic responses, while Philippines and Indonesia (also democratic countries) are less successful. Autocratic countries (although there’s no one consensus in defining a country as authoritarian / autocratic) also had its share of different results, with Vietnam coming out with one of the best responses the world has seen and a mixed to arguably controversial pandemic response from China.

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A government’s success in flattening the curve is the result of leadership and competent government administration, regardless of regime type.

Zachary Abuza, a professor at the National War College in Washington, D.C. has correlated four criteria to understand why some states have succeeded, while other states have not – Leadership, Government Transparency, Legitimacy, Planning and Preparedness.

Leadership

The pandemic is economically painful in the short run, but governments that are willing to sacrifice and decide to implement public health solutions such as early lockdowns, massive screening and contact tracing measures fared well, as is most clearly seen in Vietnam and Singapore during the first wave.

Leaders who made decisions based on medical and scientific evidence — deferring to their public health and medical officials — have come out on top, while leaders who made their public health decisions based on short-term economic and political calculations lost very valuable time. In a pandemic with exponential growth, every day matters.

Governments that used this pandemic to accumulate power, attack media, and silence critics have fared poorly. Mistrust between people and its government usually happens when leaders are granted emergency powers yet little transparency. Such as the case in Cambodia when the parliament passed a law granting Hun Sen new powers including the ability to conduct electronic eavesdropping and curtail freedom of assembly and speech. This is also true with the Philippines when Duterte’s new powers involve the ability to take over utilities and private firms.

Government Transparency

Governments that communicated with their public in a transparent manner tended to quickly win confidence. The governments that admitted the problem, communicated risks, outlined effective mitigation efforts, and spoke with one voice have fared much better than governments that have multiple speakers, leaders who downplayed the threat, have publicly reversed their policies, spewed scientific nonsense, looked for scapegoats, and repeated conspiracy theories. Greater trust led to greater compliance when it came to wearing face masks, social distancing, and self-isolation.

It’s a bit surprising that the governments that can be described as authoritarian or semi-authoritarian which are not always prone to transparency have been models of effective communication — Singapore’s Prime Minister Lee Hsien Loong and Vietnam’s Deputy Prime Minister Vu Duc Dam both know that in public health matters transparency and communication are essential.

Democracies on the other hand – which have a fairly free press, had problems. Indonesia’s president downplayed the threat, peddling about herbal remedies and lack of prayers – then publicly backpedalled and reversed these policies. Thailand’s Health sectors always tend to insist the blame on foreign governments instead of moving, and in the Philippines, the president’s press conferences drew more public ire than public trust. Even if governments had holistic strategies to deal with food supply and create broad-based stimulus package – without effective communication, will fail. And this may contribute to public noncompliance such as people violating quarantine regulations.

Legitimacy

Public trust is tied to another attribute: government legitimacy. Governments that had low legitimacy level leads to low public trust and compliance and fared more poorly. Legitimacy is based on surveys and polls if you are in a democracy, but there’s a good reason why Authoritarian governments fare better being judged on their legitimacy because it’s based on performances. Surveys and polls can be skewed in favor of the government even if they are not performing well. After coming into power in February following a coup d’ etat overturning the results from 2018 elections, the Malaysian government was seen as illegitimate. They even delayed parliament to forestall the ousted party’s no confidence vote citing “virus war” a priority. Yet it allowed its competent civil service and medical professionals to do their jobs, heeded advices and imposed strict stay in place orders; since, then their curve is flattening.

Philippines and Indonesian governments are democratic, making their legitimacy – through elections — a norm. Yet incompetent handling weakens legitimacy. Both the Philippines and Indonesian governments delayed public health measures (including the Philippine’s very delay in travel bans). The effects of government legitimacy – partnered with effective communication can be seen in Vietnam, where people have accepted the fact that the country is economically and technologically inferior to their Asian neighbors and are willing to accept quarantine measures. You see less of this in Indonesia and the Philippines, were people are likely to violate quarantine protocols.

Planning and Preparedness

Epidemiologists and virologists have been warning about a major pandemic that is fairly lethal, quickly transmissible and can leap from animals and humans. This is both knowable and known, and there is data supporting it. Voila, we are living in it now.

Governments that stockpiled on PPEs, maintained public health centered infrastructures and made sufficient investments in their health and science departments have fared better. Governments who denied this, including those that lacked good public health systems, obviously fared poorly.

Prevention is better than cure – an age old saying. Vietnam’s Medical sector is not as advanced as Philippines or Indonesia, yet they have good public health measures: testing, contact tracing, and thermometers are really cheap compared to ICUs and Ventilators.

Singapore on the other hand, while having first world hospitals and infrastructures and optimum first wave response, was hampered by their second wave because of their 300,000 migrant workers (which are responsible for their first world hospitals in the first place). This is just a reminder that public health is determined by the least common denominator. If the poorest and most marginalized within a society are not protected then no one is. That is a lesson that all governments need to take to heart.

Thailand, in spite of its political leaders have a good public health system, world class hospitals and a nationwide network of provincial and district hospitals and Based on the Global Health Security Index, Thailand had the best medical infrastructure to cope with the crisis in the region.

The Philippines, despite having one of the best Nursing and Medical Schools, has a starved public health system. Many of its medical professionals work abroad.

REFERENCES

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Austin Salameda
Austin Salameda
In pursuit of a career in medicine and the arts, Austin considers himself a non-conformist. he thinks everything returns to a baseline no matter how far things tilt from right to left. Writes sometimes, tells stories often, provokes always.

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