Managing Covid-19: A Brief International Perspective

By Judy Cheng-Hopkins

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A letter from Judy Cheng-Hopkins (Former UN Assistant Secretary-General; May 5, 2020, Penang).

SCANNING THE INTERNATIONAL media for insights into how the various governments of the world are dealing with the current pandemic, one can generalise, I believe, that there are three basic “models” of managing it at a national level. I am neither a medical doctor nor scientist so this is a lay perspective.

At one end of the continuum there is the Chinese model as exemplified in the way they dealt with the original outbreak in Wuhan in late December-early January. It is still a controversial and contentious point if China purposely delayed informing the world that human-to-human infection was possible. The Chinese government nonetheless quickly jumped into action by early February when they took the most drastic measures to lock down a city of some 11 million people. As described in the New York Times dated February 25, the government ordered “house-to-house searches, rounding up the sick and warehousing them in enormous quarantine centers”. On January 12, 2020 China publicly shared the genetic sequencing of Covid-19 which allowed several countries to develop testing kits (from WHO website and according to Kang Kyung-wah, Foreign Minister of South Korea).

Fast forward to today, Wuhan has pretty much returned, after 10 weeks, to as normal as normal can be in mid-April, and businesses, schools, restaurants have started reopening and the infection rate remains low. The WHO has praised China for its quick, decisive action which has won it the ire of the US (more later).

Much as I am loath to support this notion or “inconvenient truth,” anathema to liberal thinking, I will say this anyway: authoritarian regimes, provided they remain focused on a clear result and have the capacity to implement its plan and lastly, is not “too” corrupt (no or minimal self-enrichment) can usually achieve results much faster than can democratic regimes. See the case of China – from building a hospital in 10 days in Wuhan to eradicating extreme poverty of some 850 million people from 1981 to 2015 (World Bank), Singapore under Lee Kuan Yew going from Third World to First in 35 years, and the meteoric rise of South Korea from a gang-infested country to an industrial powerhouse under the tyrant General Park Chun-hee in the 1960s by luring back Korean graduates from the MITs and CITs.

I think the fundamental issue is not how restrictive a regime is in a time of historic need of its people (say to get out of poverty or to build back, post-genocide, in the case of Rwanda), but how to lift restrictions and allow for a more open society depending on milestones reached. Of course the reality is that these dictators never leave willingly.

Then at the other end of the continuum is the case of Sweden, a bastion of social democracy, where a strategy of herd immunity has been pursued. Certainly the Chinese authoritarian, state control, and illiberal model and modus operandi would never work here but has it gone too far off the cliff with an almost laissez-faire attitude? Unlike her neighbours Norway and Denmark, Sweden has had no lockdown, the borders and restaurants remain open, and although secondary schools are closed, kindergartens and grade schools remain open. All in the quest of having a certain percentage of the population infected with the virus and emerging with an immunity to further infection (not a proven fact according to Dr. Jemilah Mahmood, special adviser on Covid-19 to our Prime Minister). The idea is that those newly infected eventually develop immunity so that in the end almost everybody is immune and the disease will disappear.

Of course the Swedish government is aware of the special dangers to the elderly and those with pre-existing medical conditions and take care to isolate them and to properly treat them should they become ill in hospitals. The Swedish context is of course not commonplace because it has a good public health system already in place, its hospitals are well-equipped and large enough for any contingencies and mostly, people trust one another and do follow rules such as on social distancing, something one would not find in much of the world. Still, doesn’t this smell like Social Darwinism? I stand to be corrected but I keep wondering how such a developed, sophisticated, ethical country could be so cavalier in this respect?

The fact of the matter is that people will die and the death rate from the disease is in fact higher in Sweden than in neighbouring Denmark and Norway [(as of May 4, out of a population of 10 million people, Sweden has 22,721 confirmed cases and 2,769 deaths compared to populations under 6 million and the death rates of 214 in Norway and 493 in Denmark (Wall Street Journal editorial board May 4, 2020)]. Sweden argues that the trade off is that they don’t have to shut down the economy and will save jobs. From everything I have read, the wisdom and “costs and benefits” of this model is still to be determined. In other words, it is a test case that the rest of the world is watching.

Between these two extremes are the generally positive models of Germany, South Korea and New Zealand which are based on science, metrics and fast efficient action; especially in testing and isolating and contact tracing at the first sign of the disease, as well as quarantining infected people and singling out and caring for the elderly which has led to both low infection and mortality rates. The strategy of flattening the curve of new infections is to ensure that the health system and facilities are not overwhelmed and to buy time for the development of medications for treatment and a vaccine.

Is there a fourth model? Actually there is! The one followed by the richest and most powerful country in the world: the US. One of denial that the scourge exists, that it’s a “hoax” or by engaging in happy talk that it will pass like any other flu and then when it’s evident that it has arrived, to prescribe cockamamie remedies. I think your readers are well aware of these bizarre comments and remedies so there is no need to discuss them here. Bottom line: there is no strategy at the federal level and mercifully certain governors have taken matters into their own hands. Poor US to have ended up with a moron (in the words of Trump’s former Secretary of State) as President in the first place and then to have a once-in-a-century pandemic strike while he is President! Why is God punishing Americans to this extent?

Coming back to Malaysia, we have obviously followed the path of the Germanys and South Koreas, which is good. Restrictions are being eased slowly and in phases based on data. Malaysia’s MCO, now CMCO seems to have worked: with a total population of 31.5 million people, infection rates of 6,200 and total fatalities of only 103 to date present a relatively reassuring picture. But of course, to quote the US baseball player Yogi Berra, “it ain’t over til it’s over!” The recent display of independence on the part of certain state governments in developing their own SOPs and timelines within the general CMCO is a welcome sign, though, of the maturing of our democracy within the principles of federalism. COVID-19 has many unintended consequences!

I obviously cannot end my commentary on the international perspective without a word on the indispensable role of the WHO in a pandemic. WHO was created in 1948 to coordinate the fight against communicable diseases globally. Its initial priorities were malaria, tuberculosis, and other communicable diseases, plus nutrition and sanitation. From the start, it worked with member countries to identify and address public health issues, support heath research and issue guidelines. It also classified diseases.

WHO first publicly announced the appearance of a pneumonia of unknown causes in Wuhan on December 31, 2019 and then declared it a public health emergency of international concern on January 30, 2020, gave it a name – Covid-19 – on February 11, 2020. And on March 11, 2020, deeply concerned by the alarming spread of the virus and “inaction“ of some countries, declared Covid-19 a pandemic (parameters of definition met). Your readers may wish to visit their website to appreciate the important role of coordinating a global network at this point in time.

Judy Cheng-Hopkins