As the coronavirus spread to Asia, the West had a head start to prepare. Why has it not been used?

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Some of this is simply outdated – Asia has been struggling with coronavirus since the end of last year, so governments have had more time to respond, and waves of infections have increased and decreased . Europe and the United States are in the relatively early stages of their outbreaks and the numbers are also expected to slow in the coming weeks and months.

But this explanation misses a fact: the West did not have to go through the same cycles as Asia, where governments and public health systems were little aware of the virus and tried to understand it while reacting to epidemics.

While considerable attention has been paid to China’s initial response to the virus – particularly its downplaying and apparent concealment of key information during the first weeks of the pandemic – anger is growing in many countries over the failure of other governments to respond when the situation was clear.

Dr. Anthony Fauci, director of the United States National Institute of Allergies and Infectious Diseases, confirmed on Sunday reports that calls for vital social distancing measures were facing “a lot of setback” at the start of the outbreak and said the country was looking to respond more effectively to the virus if it rebounded in the fall.

Last week, the chief scientist of the European Union resigned over the bloc’s response to the virus, while in the United Kingdom, where Prime Minister Boris Johnson left hospital after being infected with a coronavirus, there is a growing scandal regarding the lack of protective equipment for first-line medical workers.

In Asia, it is increasingly surprising that the long lead times of many countries elsewhere have not been better used. This is particularly the case in China, where state-supported media have argued that the country’s response to the virus has saved the world from a much worse pandemic and that the sacrifices made by the Chinese people have been wasted by mismanagement of governments. in the West.

Many of these governments wanted to lay the blame for the virus on Beijing, but while initial cover-ups and lack of transparency undoubtedly delayed international response, by February at the latest, much of what we know about the virus – including its severity and the ability to spread quickly – was widely known, yet countries have still not acted or refused to act.

Someone else’s problem

While it is easy to forget now that the coronavirus exploded in a global pandemic, at the beginning, the worst of the epidemic seemed to be contained in China, with most of the deaths seen in Wuhan, at least in part due healthcare overflowed with the city system.

Sporadic outbreaks outside mainland China have not recorded the same levels of deaths as in Wuhan. And there has not been the kind of rapid spread within China that later came to Europe and the United States.

“I think the penny hadn’t gone down that it was really going to continue to spread,” said Benjamin Cowling, professor at the School of Public Health at the University of Hong Kong. “In Hong Kong, we picked up all of these cases and then checked their contacts, and it didn’t seem so contagious. There was an opinion that perhaps outside of China, infections would not spread as easily. “

Cowling added that “it wasn’t until about a month later, especially when northern Italy experienced this outbreak, that suddenly it was recognized that there could be a lot of transmission under the radar ”.

Cases in Italy began to explode in late February, as the country rushed to lock down Lombardy first, then much of northern Italy, finally outstripping China in number of deaths from the virus in early March.

But while authorities and experts were certainly caught off guard by the speed and extent of the spread of the virus, several experts agreed that there was also a general feeling of complacency among Western governments as the epidemic was a Chinese – or Asian – problem, and wouldn’t necessarily behave the same way within their borders.

“There is often a feeling in countries that they could be affected in a different way because their community has a different structure … or that the warm weather will keep it away, or that their community is larger,” said Cowling. “But I think what we’re finding out is that Covid-19 is affecting all over the world. “

Nadia Abuelezam, epidemiologist and assistant professor at Connell School of Nursing at Boston College, said that “despite a number of scientists warning (American) leaders that an epidemic of this magnitude could occur, little was done to get ready ”.

She attributed this in part to the underfunding of the US health care system, but more broadly “there is still a lot of stigma and xenophobia in society that public health officials and other members of society are trying to fight “.

“Unfortunately, this stigma has provoked a slow response and has led to a large number of deaths and infections around the world,” she added.

Failure to act

Despite all the blame on China’s door for its failure to act at the start of the pandemic, officials did not know what they were facing.

In comparison, officials in Europe and the United States knew exactly what they were facing once the epidemic reached their borders, but were often slow to respond, wasting time as the virus spread through Asia and ignoring the lessons learned from other countries.

Much of what we know about coronavirus – that it is highly contagious and spreads from person to person, that it has a relatively high mortality rate, especially for certain populations, and that l One of the best ways to contain it is through distancing – was established in early February.

Despite this, Western governments, particularly the United States and the United Kingdom, have been incredibly slow to act.

In the United States, national guidelines for social distancing were not put in place until March 16 – the country’s first case was registered on January 15 and the first signs of “community spread” were detected late. February. The UK has also dragged its feet to take concerted action, only instituting blockades and home maintenance orders in late March, two months after its first case was registered.

Both countries also struggled to test enough people, with the U.S. experiencing delays due to the publication of a faulty test that needed to be corrected, and the UK still lagging behind many. its European neighbors, which has led some to turn to postal mail kits. .

It should not be like this: as of January 21, while even the authorities in Beijing were only strengthening national efforts against the virus, across the Taiwan Strait, their counterparts in Taipei introduced new restrictions on travelers from from mainland China. They would continue to deploy new measures in the weeks that followed, which successfully contained the spread of the virus on the island.

This cannot be attributed to a lack of information from the United Kingdom and the United States. Taiwan is not a member of the World Health Organization (WHO) and has publicly complained of a lack of data sharing because of this (an accusation the organization denies). However, it was able to establish a world class response based on publicly available information.

New Zealand, another government that has been praised for handling the pandemic, has also been quicker at introducing large-scale restrictions and tests than Washington or London.

“We have the same access to the same knowledge as you – the whole world saw it happen, it’s like a slow-onset tsunami, it hasn’t changed its characteristics at all, and the virus is very stable,” said declared the professor. Michael Baker, who helped advise the New Zealand government on his response, told CNN last week.

Not all Western countries have been as slow to respond as the United Kingdom and the United States. Germany was praised for its response – maintaining a low number of deaths despite an increasing number of infections, in part thanks to a well-funded universal health system and generalized tests allowing people to receive treatment or d ” be isolated if necessary.

The last war

It’s a well-worn cliché that armies fail when they try to wage the last war in the next, but crisis responses are also shaped by past experience, regardless of how much we try to look beyond. .

From the outset, the current pandemic was seen as a resurgence of SARS, from its onset in China, to this government’s apparent attempt to cover up, until it spread to Asia. The two viruses are related and have similar symptoms, but the new coronavirus has long since overtaken SARS in terms of death and spread.

However, the inability to look beyond SARS may have shaped the responses in both positive and negative ways. In East Asia, which was hit hard by the 2003 epidemic, it has put governments and the public on its guard, as people are quicker to wear masks and exercise social distancing.

Taiwan has been hit hard by SARS, and its rapid response to the current pandemic has been led by the National Health Command Center (NHCC), a high-level coordinating body established in 2004.

But while SARS may have led to faster action in one part of the world, the 2003 epidemic may have led officials elsewhere to take the opposite approach.

“I expected a quicker response as we have dealt with SARS and MERS and other recent health threats,” said Henry F. Raymond, associate professor and epidemiologist at the Rutgers School of Public Health , about the American management of coronavirus. “But on the basis of the same experiences where these epidemics were relatively slow to move and for the most part quickly contained, they may have contributed to more complacency than was justified. “

This complacency, combined with calls to preserve the economy at all costs, seems to have prompted some officials to refuse to face them or to be yelled at by increasingly desperate scientific advisers.

Even in Hong Kong, Cowling said that he could not bring himself to believe that this virus was going to be much worse than what we had seen previously.

“Scientifically, I knew it was spreading. But I still didn’t really know how to say it, “he said. “I remember very well that there was an article I wrote where I changed the word ‘pandemic’ to something like ‘global epidemic’ because I felt like no one would believe me if I said it would be a pandemic. “

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