COVID-19 and global response: Lessons and hope

Saqib Khan
On 1 April, the
United Nations Secretary-General Antonio Guterres described the coronavirus
pandemic as “humanity’s worst crisis since the Second World War”. So, what has
been humanity’s response to this crisis? How have different countries responded
to it and what are the steps they have taken or are taking to tackle it? This
article attempts to explore these questions by taking some of the countries and
looks out for hope.[1]

Flattening the curve through humongous effort
One of the turnarounds of the current pandemic happens
to be from China and it has important lessons for humanity. From being the global
epicentre and reaching more than 80,000 cases by March 7 and more than 3000
deaths since the beginning of the outbreak in December 2019, China did a huge
turnaround. On February 18, China’s daily infection figures drop below 2,000
for the first time since January and by mid March, no new local infections came
up for the first time since the coronavirus crisis began.[2]
Life in China’s epicentre- Wuhan (Hubei province) – began to limp back to
normal by the end of March and beginning of April. China has recently said that
it has now all but stopped the spread of the disease and the authorities have
started to allow gradual access to Wuhan, the city in Hubei province where the
outbreak began.[3]
On the other hand, the global epicentre soon shifted to Italy and Spain in
Europe and the USA by 20 March. The question then arises- how was it done in

Broadly, it was a
mix of lockdown, strict quarantine, mass testing & contact tracing. With an
analysis of 25,961 laboratory-confirmed COVID-19 cases, research papers like Wang
et al (2020) conclude that considerable countermeasures have effectively
controlled the outbreak in Wuhan. A series of interventions were implemented by
Chinese authorities. These included lockdown in Wuhan city from January 23,
social distancing measures including compulsory mask-wearing in public places
and cancellation of social gatherings, implementing the policy of centralized
quarantine and treatment of all confirmed and suspected cases, those with fever
or respiratory symptoms, as well as close contacts of confirmed cases in
designated hospitals or facilities. Thousands of doctors and medical personnel were
deployed from other areas into Wuhan, two new hospitals were built for those
infected by the virus, and various civic bodies went into action to assist
families under lockdown (Prashad et al 2020). The country also engaged in mass
testing, having conducted over 320,000 tests by the end of March.[4]

Wang et al (2020) demonstrate
that the aggressive disease containment efforts, including isolation of the
source of infection, contact tracing and quarantine, social distancing, and
personal protection and prevention, considerably changed the course of COVID-19
outbreak in Wuhan, when there was neither effective drug nor vaccine for this
new infectious disease with high transmission. What the Chinese authorities did
to stem the rise of the infections was to put those infected in hospitals and
those who had been in touch with them into quarantine. This targeted policy was
able to identify those who had been in the chain of infection and thereby break
the chain (Prashad et al 2020). Their analysis has important implications for
other countries especially where there is a sharp surge in cases and who are in
the early stages of the epidemic. With ready preparedness, prompt response and
evidence-based strategies, the global community can be united to battle the
seemly unstoppable pandemic.
A recent report by
the World Health Organization (WHO) says that given Wuhan’s status as a
transport hub, population movement during the Chinese New Year and rapid spread
of infected individuals outside Wuhan, a comprehensive set of interventions,
including aggressive case and contact identification, isolation and management
and extreme social distancing, were implemented to interrupt the chains of
transmission nation-wide. A policy of meticulous case and contact
identification for COVID-19 was adopted. For example, in Wuhan more than 1800
teams of epidemiologists, with a minimum of 5 people per team, were tracing
tens of thousands of contacts a day (in mid-February). However, this is not to
say that there are no limitations or knowledge gaps. The report points out that
despite the amount of knowledge gained about a new virus in a quick time, key
knowledge gaps remain. And the timely filling of these knowledge gaps is
imperative to enhance control strategies (p. 16). 

Along with
tackling the pandemic, a key issue that China has been facing is the false
narrative and propaganda mainly by some Western media agencies that it “covered
up the outbreak” and “did not do enough to contain it”. Evidence, however,
rejects this narrative. 
Though reports say
that the first patient was identified with symptoms in early-December and one
can say that China could have acted more swiftly, the key point here is that
there was confusion and lack of clarity in identification of the virus and its
characteristics due to its novel nature. The provincial authorities could
understand the new virus only by December 29 and on 31 December 2019, China
alerted the WHO to several cases of unusual pneumonia cases in Wuhan. The virus
was identified by 3 January and on 10 January China shared whole genome
sequences of the COVID-19 virus with WHO and international database (Prashad et
al 2020).[5] On
January 8, China confirmed that the novel coronavirus was indeed the source of
the outbreak. The first death from the virus was reported on 11 January. On
January 14, the Wuhan Municipal Health Commission said that there was still no
evidence of human-to-human transmission, but they could not say with certainty
that limited human-to-human transmission was impossible (Prashad et al 2020).
Even the WHO on 14 January had reported that
there was “limited human-to-human transmission between close contacts
and assessed that there was no clear evidence of sustained human-to-human
Wuhan went into full lockdown on January
23, three days after human-to-human transmission of the virus was established (Prashad
et al 2020).[6]
Secondly, the
steps taken by China were appreciated by a WHO team that visited China from
February 16 to 24 which said in its report: “In the face of a previously
unknown virus, China has rolled out perhaps the most ambitious, agile and
aggressive disease containment effort in history. The remarkable speed with
which Chinese scientists and public health experts isolated the causative
virus, established diagnostic tools, and determined key transmission
parameters, such as the route of spread and incubation period, provided the
vital evidence base for China’s strategy, gaining invaluable time for the
response. Containing this outbreak, however, has come at great cost and
sacrifice by China and its people, in both human and material terms” (p 15-17).
Thirdly, the drop
in new daily cases by mid-March, lower total cases and deaths compared to
European countries like Italy and Spain, and US and the subsequent shift of the
epicentre from China bear testimony to the success of the quick steps taken by
it to contain the pandemic for now. Lastly, along with these steps, China has
also sent its doctors and medical supplies to several countries currently
battling the pandemic keeping alive the spirit of internationalism and global
Korea: Widespread, free testing and extensive contact tracing
South Korea has
presented us with a model where it did not enforce China-like lockdown. Here,
mass congregations by members of a religious cult from 31 January to 2 February
in Daegu were identified as the hotbed for the spread of infection. On February
20, South Korea reported its first death from the coronavirus and daily new
cases peaked by the first week of March. Thereafter, it started falling and the
total active cases also started falling by mid March. With about 10,000+ cases,
South Korea’s death count remains relatively low with 174 deaths till now and
deaths per 1 million population being 2. This is lower than several developed
countries in the West.  Its current
mortality rate is 1.7 percent.
It has been argued
that this was made possible due to the most expansive and well-organized
testing program in the world. The country swiftly developed a test for the
virus – and has now tested more than 300,000 people free of charge and its testing
rate per million remains one of the highest in the world. Starting with
conducting about 10,000 tests daily for free, it scaled its testing capacity
rapidly to about 20,000 tests per day with turnaround times between 6 and 24
hours. Authorities used techniques like telephone consultations, drive-through
test centres and thermal cameras to detect infections. It also had rapid
approvals system in place for infectious disease tests, following an outbreak
of Middle East Respiratory Syndrome (MERS) in 2015 that had left more than 30
people dead. Reports suggest that its government and few private firms had
begun developing and stockpiling
test kits well before the country had its first outbreak.[7]
 A key component of testing was to find and isolate asymptomatic
carriers before they could spread the infection unknowingly.
combined mass testing with extensive efforts to isolate infected people and
trace and quarantine their contacts.[8] Thus,
South Korea mainly adopted restrictions and focused on widespread testing and rigorous
contact tracing and quarantine rather than complete lockdown. The size of
population, however, also made it relatively easier to avoid complete lockdown
compared to countries like China or India. 
Delay in responding and gauging intensity
By the first week
of March, Iran was the worst-hit countries in the world next only to China. In
Asia, Iran remains the country with the second highest cases (50,000+) after
China but with a relatively high rate of death (3000 deaths and 38 deaths per
one million population). It looks set to surpass China in the number of deaths
even with fewer cases than China as it is still reporting more than 100 daily
deaths. In mid-March the dead in Iran included a dozen politicians and
officials. The number of total cases is also expected to rise; from a peak of
more than 3100 on 30 March the number of daily cases is hovering around
2800-2900 currently. The city of Qom was reported to be the epicentre of Iran’s
epidemic. Although Iran has one of the best medical systems in West Asia, the
number of cases and deaths overwhelmed Iran’s healthcare system.
Iran’s delayed
response and failure to recognise the infection’s intensity is best summed up
by the remark of Deputy Minister of Health and Medical Education Iraj Harirchi
in a press conference on 24 February where he had said that “Quarantines belong
to the era of past”. Next day, Harirchi announced that he had been diagnosed
with COVID-19, and had self-quarantined.[9]

went ahead with its Feb. 21 election and kept popular shrines like Fatima
Masumeh in Qom open till very late which were visited by thousands. Though the
government has now closed shops, schools, universities and shrines, banned
cultural and religious gatherings and widened travel restrictions, it has not
imposed complete lockdown so far.[10]

With the
assistance of WHO, progress has been made in scaling up the number of
laboratories that are now able to test for COVID-19 and availability of testing
kits and protective equipment and supplies.[11] An
important factor in Iran’s struggle against the pandemic is the fact that its
healthcare has been compromised due to the sanctions imposed by the US since
2018, particularly medical supplies. This is in spite of recent calls by the UN
to countries to urgently re-evaluate sanctions against several countries. Its desperate
situation can also gauged from the fact that probably for the first time in six
decades, Iran has requested emergency funds from the International
Monetary Fund to help it fight the crisis.
Scrambling resources amidst ill-planned lockdown
In South Asian countries like India, total cases
gradually increased from mid March, its pace picked from 20 March and is seeing
rapid increase since the start of April and reaching almost 3000 (with daily
cases touching 600 on 1 April and still hovering around 500+ cases).
India’s broad strategy
has been to put a national lockdown and scramble medical supplies and
healthcare together during this time. However, given the state of public health
in a country where there is 1 hospital bed for 1800 people, 1 isolation bed for
84,000 people and 1 ventilator for about 300,000 people, it is certain that
India has a herculean task in its hands.
Besides, questions
and concerns have also been raised about delays and the level of preparedness.
The country reported its first case on 30 January, but authorities held that these
were one-off cases and no local transmission was taking place (Krishnan 2020).
The realization of the scale of the coming problem perhaps came only by mid-March
when total cases touched 100 and which are now seeing an exponential growth;
all this when there was ample information of its rapid global spread since
late-January and February 2020. However, the central government seemed to be
preoccupied with extending a red carpet to the US President in the last week of

For India, the
delay in extending home quarantine to incoming passengers at airports and
expanding testing criteria could prove vital. Home quarantine was limited to
incoming travellers from only about a dozen countries till 16 March even though
the virus had spread to 60+ countries by 2 March. It was finally extended to
incoming travellers from all countries on 17 March. With regard to testing
criteria, the initial guideline of Indian authorities was to test only
symptomatic individuals who had undertaken international travel in the last 14
days and their immediate contacts; it was revised & extended to include all
hospitalised patients with acute respiratory infections, including pneumonia,
and asymptomatic contacts of a confirmed case on 20 March. In fact a recently
published study by Indian Council of Medical Research (ICMR) scientists
indicates that early and widespread community testing is critical & much
more effective at flattening the curve than airport-screening. India might have
missed the opportunity of a South Korean-type response, to test and isolate
(Pulla 2020).  
Second, concerns have been raised about the
availability of Personal Protective Equipments (PPEs) and other supplies and
overall preparedness. It has been claimed by PPE manufacturers that “India lost
around five weeks in the production capacity of PPEs due to delayed government
Despite WHO’s guidelines of 27 February warning the countries of shortage of
the global stockpile of PPE, medical masks and respirators, it was on 19 March
that the central government finally issued a notification prohibiting the
export of domestically manufactured PPEs as well as raw material for the same. And
further five days to ban the export of respiratory apparatuses. Despite claims
of procurements of materials, there have been various reports of doctors
resorting to wearing raincoats, helmets and other alternatives due to the
shortage of PPE kits, and getting the infection remains a major concern among
the healthcare community.

The increase in cases finally led the Prime Minister
of India to announce a nation-wide 21 days lockdown on 24 March (in effect from
24th midnight). However, it was evident that it was not carefully planned by
the government and ill implemented. The shutdown of the train network on 23rd
March and the lockdown saw an exodus of workers from across the Indian cities
to their hometowns in different states- with hordes seen walking home even
hundreds of kilometres away due to closure of most work after the lockdown. While
most wealthy and middle-class Indians will make it through the lockdown period with
stored rations, work from home and so on, it’s clear that the country’s poor
and its millions of workers particularly in informal sector will struggle to
survive without work or enough food (Krishnan 2020).  Recent data shows while COVID-19 infection has
killed around 100 people, 86 have died due to poorly planned lockdown and
corona-related issues (hunger, exhaustion, etc).[13]
Even advisories like social distancing are impractical in a country where a
significant share of the population lives in dense clusters in cities. Continuance
of religious functions of different faiths as late as lockdown and even after
it, public gatherings in the evening of ‘Janata Curfew’ on 22nd March, calls
for unscientific ‘cure’ of COVID-19 by members of the ruling party and groups
owing ideological allegiance to it, half-baked social media messages by
citizens, and racist attacks on people from the northeast region certainly
dented India’s fight against the pandemic.

The lockdown may help “flatten the curve” and buy the Indian
authorities some time, but it has to be accompanied by aggressively testing,
isolating confirmed cases, and performing contact tracing. Despite improvement
since March, India’s current testing rate still remains abysmally low in the
world. The cost of Rs 4500 for testing in private hospitals has not helped. Though
the country has not reached the case levels of Italy, Spain or US, flattening
the curve will require planned concerted efforts. And there has to be a
concrete plan for the period after the current lockdown ends on 14th April. The
challenge before a country like India is to craft a policy that effectively
tackles the epidemic as well as supports the livelihood of millions of people who
are out of work (Purkayastha 2020).  

In India, states
like Kerala have stood out. One of the vital reasons for this has been the support
to the public healthcare system and attempts to improve it by Left Front
governments in the state. Efficient planning and coordination, quick response,
contact tracing, breaking the chain of infections and public welfare measures
have been the hallmark of the state’s response to the epidemic. The state
closely followed the rise of the cases in Wuhan and began taking measures as
early as 26 January 2020. The state’s Health Department set up for various
tasks, and the Health Minister and Chief Minister held daily press conferences.
The state has led the way in the fight against the coronavirus pandemic by enacting
key public health measures as well as welfare measures to protect the
population. Its current testing rate of 257 is the highest in India and far ahead
of other states. Kerala initiated the ‘Break the Chain’ campaign by conducting
rigorous contact tracing, involved a PSU and youth organisations in producing
hand sanitizers and gave the slogan of ‘Physical Distance, Social Unity’ (Dennis
and Prashad  2020). Among the several
welfare measures, it has opened community kitchens, set up more than 4600
relief camps for migrant workers whom it called ‘guest workers’ and began home
delivered food for school children.
(Italy, Spain, Germany)
By mid-March, Europe
had become the epicentre of the pandemic with cases rapidly increasing in
countries like Italy, Spain, Germany and France. The situation particularly
became critical in Italy and Spain that soon overtook China in terms of total cases
and deaths.
Undetected transmissions and demographic factor
For a week between 20-27 March, Italy was recording
almost 6000 daily new cases. Though now it seems to have fallen to less than
5000, the number of daily deaths still hover around 700.  The extent of Italy’s health crisis can be
gauged from its fatality rate from
the virus, which was running at 5 percent nationwide and 6 percent in the
worst-affected Lombardy (one of Italy’s wealthiest regions), higher than the 3
to 4 percent estimates in most other countries (like China 3.8 per cent); it is
now almost 12 per cent for Italy. The pictures of Italian hospitals and morgues
being overwhelmed with hundreds of daily deaths have presented a grim picture.

plausible explanation in Italy’s case was the undetected

transmissions in early stage of outbreak.  It is now believed that the virus had been
circulating unnoticed in northern Italy via other local chains of infection,
probably since mid-January- thriving because so many of the infected had no
symptoms at all, or only mild symptoms like a cough and a mild temperature.
This is consistent with recent research suggesting that the virus can be spread
by people who do not yet show any symptoms.[14]
travel by 40,000 football fans from Bergamo to Milan’s San Siro stadium on 19
February for the Champions League football match between Atalanta and Valencia
has also been seen to have escalated the infections. The match was held two
days before the virus suddenly emerged in Codogno town about 40 miles from
Bergamo. More than a third of Valencia players and coaching staff also tested
positive for the virus.[15]

Age profile seems to be an important factor in the case of
Italy. With about 23 per cent of Italians over 65 years old, the country has
the second-oldest population in the world after Japan and the
oldest in European Union (EU).  This
segment of the population is more likely to have pre-existing conditions. And
it is no surprise when the report of its National Institute of Health’s (ISS)
states that 85.6 percent of those who have died In Italy were over 70.[16]
After putting the state of Lombardy and 14 other areas
in the north region under quarantine on 8 March, Italy imposed a nation-wide
lockdown from 10 March till 3 April. Though the number of daily new cases and
deaths seem to have fallen since their peak in the last week of March, its
measures to ‘flatten the curve’ do not seem to be working. It has been argued
that Italy needs to change its strategy by setting up centres to separate
people with suspected symptoms from their families. Going to the homes of people,
testing them and their family members and isolating them outside their homes
was important. It has been claimed by Italian scientists that adoption of this
strategy in areas like Veneto also perhaps explains a lower fatality than say a
region like Lombardy.[17]

Testing delay and shortage of supplies
Spain along with Italy currently remains the epicentre
in Europe and the world.  It currently
has the second highest number of total cases (after the USA) and the second
highest number of deaths (after Italy) in the world with a fatality rate of 9.4

Delay in testing and availability of equipments have
been some of the key issues facing Spain. The first positive cases of
coronavirus on the Spanish mainland came on February 26, including in both
Madrid and Barcelona, the country’s two most important cities. It was only then
that the government realized the urgency of large scale and rapid testing.
However, the diagnostic capability of its healthcare system was limited and
there was shortage of testing kits and protective gear for health workers.
Coordination between Spain’s national health care
system and the 17 regions that administer it separately was also a major issue.
Spain solved the problem by temporarily nationalizing all the country’s private
hospitals. Part of the problem was that while Spain has a national health care
system, each of the 17 regions actually administer it separately. That,
according to health labour leader Hernández Puente, caused a lot of
coordination issues early on, including leaving doctors ill-supplied to provide
care. The central government has now tried to address this disconnect by
temporarily nationalizing all the country’s private hospitals.[18]  

As late as first
week of March, the Spanish authorities had not prohibited large gatherings like
soccer matches and political rallies. It was finally on 14 March that a
national lockdown was announced. The consolation for Spain is that the daily
new cases have fallen from a peak of 8200 cases to about 7000 cases now.
Early and free, extensive testing
Germany remains an outlier not just in Europe but
among all the countries in the world having substantial cases.  This is both in terms of total deaths and the
fatality rates. With an almost one lakh case, it has seen about 1500 deaths and
its deaths per million population ratio is 17 and fatality rate of 1.5 percent.

We see that though Germany and Italy have a similar
percentage of adults aged above 60, the median age for confirmed cases of
Covid-19 is 47 years in Germany, compared with 63 in Italy. Germany has somehow
not got its elderly infected as much as a few other nations like Italy and this
has translated into a lower mortality rate.

The most important factor contributing to the low fatality
rate in Germany appears to be extensive and early testing which is free.
Extensive testing began as early as mid-February and helped to treat the
identified and also in contact tracing mechanisms. In March, it was testing
about 120,000 people a week, now its laboratories are testing between are carrying
out between 300,000 and 500,000 tests for Covid-19 every week.[19]
Second, it is the presence of a robust and strong healthcare system. Germany spends $4,714.26 per person each
year on healthcare and Germany has 621 beds per 100,000 people compared to 275
in Italy has, and 293 in Spain. This along with a
decentralised medical
system run by municipalities and district administrations and testing process
helped.[20] As a way of dealing with the pandemic,
it too imposed a strict lockdown from 24 March with severe fines for breaking
the rules.

Americas (US, Brazil, Cuba)
US: Denial, delay and crippled healthcare
By the last week of March, the USA became the
pandemic’s global epicentre; it currently leads the world with more than
300,000 total cases and 10,000+ deaths. A dismissive President, delay in action
particularly widespread testing, and a dysfunctional healthcare system appear
to be the reasons for the scale of crisis unfolding in the USA.

The USA was informed about the severity of the problem
in early January. It reported its first case on 20 January and the first case
of person to person transmission on 30 January. However, these were taken
casually by President Trump and he did not prepare the country to address the
pandemic. In fact till late February and early March, Trump was in denial mood
of its existence and severity, calling it ‘hoax’, ‘very mild’ and that ‘it will
disappear like a miracle’.[21]

24 February, Trump claimed that “the coronavirus is very much under control in
the USA”. He did not declare a
national emergency till March 13, by which time the virus had begun to spread in
the United States (Prashad et al 2020). The approach of ‘business as usual’ and
refusal to implement either a South Korea-like approach of mass testing,
contact tracing, and quarantining carriers and people or China-like approach of
lockdown plus testing, etc by Trump did not help matters. 

It was only from
early-March that the USA began expansive testing. And with the capacity it had,
the criteria for testing remained extremely narrow for several weeks: only
people who had recently travelled to China or had been in contact with someone
who had the virus. Even now tests are being saved for the most serious cases
due to lack of testing kits. The crucial delay when the crisis grew undetected
and exponentially proved to be the deciding factor. And this was pointed out by
none other than the country’s top disease expert involved in the fight against
the virus and the director of the National Institute of Allergy and Infectious
Diseases, Dr Anthony Fauci, who told members of Congress that the early
inability to test was “a failing” of the administration’s response to a deadly,
global pandemic.[22]
This in turn was due to a lack of preparation and a
dysfunctional healthcare system. It was not until 29 February, almost six weeks
after the first case of coronavirus was confirmed in the country that the Trump
administration allowed laboratories and hospitals to conduct their own Covid-19
tests to speed up the testing process. Hospitals continue to face severe
shortages in testing and protective equipment for medical staff working to combat
the coronavirus outbreak. The findings are in line with pleas made by
governors, medical workers and hospital administrators, but they contrast
sharply with statements made by Trump that things were under completely under

The USA was less prepared for a pandemic than
countries with universal health systems. High health care costs and low medical
capacity made the US uniquely vulnerable to the coronavirus.[24] On
top of that, the Trump administration proposed a 16 percent cut in the Centers
for Disease Control and Prevention (CDC) funding on 10 February – 11 days after
the WHO had declared a public health emergency over COVID-19.

Lastly, use of terms like ‘China Virus’ by Trump
administration not only shows a deeply engrained racism but also attempts to
shift its own inefficiency in dealing with the pandemic.  With the country still reporting 30,000+
daily new cases, the USA has a serious task in its hands to flatten the curve. 

Denial could lead to disaster
In Brazil, the approach of President Jair Bolsorano
has ranged from denial to downplaying the threat of the pandemic- a somewhat
similar response like his US counterpart Trump. From calling it ‘little flu’
and refusal to follow the WHO’s guidelines of self-isolation and closure of all
non-essential service, Bolsonaro has even exhorted people to go out more during
a public health emergency. Business seems to be the bigger concern for him than
the pandemic.[25]

The comment of Bolsonaro’s health minister that
Brazil’s healthcare system might collapse by the end of April must be taken
The first death in Rio de Janeiro, a housemaid who had to continue working
during the pandemic and whose employer had just come back from Italy, and the
rise in total cases and deaths are an indication of the crisis facing the
country, particularly the millions of poor living in favelas. 
Upholding internationalism and effective public healthcare system
Amidst the global
pandemic, the island nation of Cuba stands out by once again showing a
humanitarian approach and upholding the spirit of internationalism. Cuba has a
tradition of sending its doctors and nurses to help with humanitarian crises
all around the world since its 1959 revolution. Keeping with that tradition, it
has dispatched six medical aid teams to several countries including Italy to
combat the pandemic.[27] On
16 March, it allowed the British cruise ship MS Braemar that had been turned
away by several Caribbean ports to dock on the island and enabled the
evacuation of the more than 600 passengers onboard and treatment of the sick.
Though the number
of cases in Cuba is still below 500, the country which is known for its preparedness
to tackle disasters and emergencies is stepping up measures at home too to stem
the contagion. This is despite the fact that it is a poor country which often
experiences shortages due to economic embargo by US. The country combines a
completely socialized medical system that guarantees health care to all with
impressive biotech innovations. Its anti-viral drug (Interferon Alfa-2B) has
been used to treat infected patients both inside the country and in China. Cuba
also boasts 8.2 doctors per 1,000 people — well over three times the rate in
the United States (2.6) or South Korea (2.4), almost five times as many as
China (1.8), and nearly twice as many as Italy (4.1). Many of its nationalized
factories have been repurposed to dramatically increase the supply of masks.
Cuba’s response to the coronavirus pandemic — from sending doctors to other
countries to pioneering anti-viral treatments to converting factories into
mask-making machines—has put even developed countries to shame.[28]

and hope
We see that
countries have responded differently to the COVID-19 pandemic. It was lockdown,
quarantine, testing and contact tracing in China, whereas countries like South
Korea deployed mass, free testing and innovative ways to detect infections and
keep the fatality rate low.

Timing and the
state of healthcare system have been crucial factors in this pandemic. In South
Korea, early development and stockpiling of testing kits helped. On the other
hand, there was delay in response and failure to recognise the infection’s
intensity in countries like ran. Similarly, there was a failure to detect
transmissions in early stage of outbreak, particularly the asymptomatic cases,
in Italy and delay in testing in Spain which proved to be disastrous. On a
similar note, there was denial and delay in widespread testing in US. Denial
and downplaying the scale of the pandemic was also seen in Brazilian
President’s approach.
In South Asia,
countries like India began taking effective steps only from mid-March and then
started putting together medical supplies amidst national lockdown. The state
of Kerala has stood out in the country. In India, flattening the curve with a
dismal public healthcare system as well as ensuring the welfare of millions of
working population will be a challenge. In Europe, Germany has proved to be a
case-study by keeping its fatality rate low mainly due to extensive and early
testing which is free, and strong and decentralised healthcare system. This is
in stark contrast to healthcare system of US which is struggling to cope with
more than three lakh cases. Countries like Cuba have once again showed us the
value of an effective public healthcare system and international solidarity.

In these difficult
times, countries like China, South Korea, Germany and Cuba, and the state of
Kerala in India have given us hope. We do not yet have the cure for COVID-19,
but one thing is clear: the approach of denial or downplaying its scale will be
disastrous. Instead, political will, robust public healthcare system, welfare
measures for the masses, renewed faith in science, innovative techniques, and
international solidarity are needed in strong doses in this battle against

The author is PhD scholar, TISS, Mumbai

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[1] This article does not deal with
the economic relief packages announced by several countries in the wake of the
current pandemic.
[2] All data related to COVID-19 cases
and deaths stated in this article are taken from unless otherwise stated.
See also
and Report of the WHO-China Joint Mission on Coronavirus Disease 2019
(COVID-19), 28 February 2020.
[26] See This article also argues for
seeing a linkage between the inefficient response to the pandemic by Trump,
Bolsonaro, Johnson and Modi.